2403_AMBROSE, MARION AND RUTH_20121108

CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K - ,
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
State
Phone Number
Type and Dimensions of Project 1Z(t) i,(,,A , 44 k,
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit
requirement pursuant to 15 NCAC 7K . This exemption
to CAMA permit requirements does not alleviate the necessity of
your obtaining other State, Federal or Local authorization.
02403
Zip
This certification of exemption from requiring a CAMA permit is
valid for 90 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
SKETCH (SCALE:
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Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2)awritten statement.has-been obtained 4rom-adjacent
landowners certifying -that they-.have--no--objeetions--to the
proposed work.
Applicant's signiture
CAMA fficial's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K
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