General Permits (8249)

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CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 1&NCA48-ftbchapter71<-.0203" r%;c C,; f t_
Applicant Name r r ' + sir t,"iF t�;l��J' "'��"'j Phone Number ? �-
Address �'O
City �,, -.t: %,: -Z 'K ,.•' State Ive" zip Ae / o'
Project Location (County, State Road, Water Body, etc.) ,�,%� s L.- ��fG1 rG6�t"/ Tel ®F���P �i/� i `%�� .�r� .I✓.>
Type and Dimensions of P
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 NGAIC-7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any othe .State, Federal, or Local authorization.
4'c
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: 1 1. ,
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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) a written statement has-been obtained from adjacent
landowners certifying that they have noobjectionsto--thee•
proposed work.
Applicant's signature
C.�MA Official's signature
Issuing date ,
Expiration date
Attachment. 15 North Carolina Administrative Code; 7K .0203