General Permits (8258)

CERTIFICATION OF EXEMPTION Pxara
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FROM REQUIRING A CAMA PERMIT OCT 19 2C11
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resounm ssion
in an area of environmental concern pursuant to 15 NCAC Subchapter 7t< :02,03:- 4 VI —VAo;
Applicant Name (fir . , Phone Number(�i
Address
City State J.uc Zip d :3 4 & C1
Project Location (County, State Road, Water Body, etc.) 14 o u. ,1 < e. L. c. i A 14 Y t of Ii a a' A I t>4 +..L K
5 `,\ A Il-r
Type and Dimensions of Project Yl 96 i3. IK1++. [� A ` ,.,:..,.. �j ���..� Sf�r.v. " pia < k fr: It { ro
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.N.CAC.7.K..0203.-This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
G •S 1%3A :, (TVbV0
This certification of exemption from requiring a CAMA permit is
•va4&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.
I SKETCH (SCALE:
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-ha&been-obtain-elil(o—m a lacen
landowners.__q& ifyingy that_ the ve_no_-objections-to -ttre
proposed wo*
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A,olh4e� *k -t,; rtp`tr ISVIVI . A
Official's sign
1 L`
Issuing date
Expiration date
--Attachment:-15 North GaroMa•Administrative•Code--7K-.02e3