General Permits (8228)

T' tV is
CERTIFICATION OF EXEMPTION RECEIVED--�'�
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, NOV d 1 2011
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission a
in an area of environmental concern pursuant to 15 NCAC Subohapter 7K :•0203. �_,
DCM-1? CITY
Applicant Name Phone Number
Address
City State zip u 1S `r
Project Location (County, State Road, Water Body, etc.) K i2 d 4 i).. 4 �^ S <.< Lot Jr a
Type and Dimensions of Project 10 r
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15-NCAC 7K .-0203, This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA permit is
valid for90 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:
/ r � f.
P+�rkr��
V ♦
I
`{{
r
OIt k V el .. ,.r ,� ?. l
i
i
L
A., •rhn nr^rnn lc with n eiovalnnmont withniit tho rnn-
X
'
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 obtain-od-from adjacent
landowners -c-ertifyiAg--that--they- have--ne objecion&, o.,M-e---
proposed-vVo ik:-- -
Applicant'. ignature
--CAMA`Official's signature
Issuing date
Expiration date
Attachment: 15-N6rth-Carotina Administrative Lode 7K-.€ 9&3