2132_BAUWENS & SAVIANO_20121108

Applicant Name
Address__
City
Proiectlocatior
CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT IEC 1 1 2012~`' 2132
as authorized by the State of North Carolina, 111
Department of Environment and Natural Resources and the Coastal ResotP
in an area of environmental concern pursuant to 1-5-NCAC-Subchapter yK - � � , -//S
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r Body, etc.)
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State
Zip
Type and Dimensions of Project 1/1A ele
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA pen -nit
requirement pursuant to 1�5-NCAAC 7K-- This exemption
to CAMA permit requirements does not alleviate the necessity of
your obtaining othe State, Federal or Local authorization.
r SKETCH /r' t GAG art°►.f�I�,/.�/ /��li >�
This certification of exemption from requiring a CAMA pen -nit 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.
(SCALE: �D )
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) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
i
CAWA Official's signn ture
Issuing date
Expiration date
Attachment: -15 North Carolina Administrative Code