General Permits (8239)

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Applicant Name
Address' s
City%
Project �ocatior
type
��CEIVED .
CERTIFICATION OF EXEMPTION i0L
2ot2
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, ��•A;�p.T 1
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15-NGAC­SubchapterilE-@2-&3
Phone Number 91A­ ,3Z- J-
(County, State Road, Water 1
2 ;? .,-( t-I-. .
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 -NGAO 7K -0203' This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local auutth`oriz ti
SKETCH
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.
(SCALE: )
,� rl'"�ii,'� Cyr fr�r. :,y''s'�Jl �✓ �/c-� i ..5 1l�
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 hasbeen-obtained-from adjacent
landowners, -cerVy4ng--that- they -have''no­objections to —the
proposed'worK."
L'/li tG U'1r'7
Applicant's signature
CAMA Official's signatu e
, 12
Issuing date
Expiration date
Attachment: 15 North -Car oli.na.Adminisitrat+ve-Code 7i -@209