General Permits (8277)

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Applicant Name
Address 03
City
Proje-9 Locatipr
Type and Dimensi
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 15 NCAC Subchapter 7K .0203. Lys,, �-� 7�%!
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ad, Water Body, etc.)
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 .0 03. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
This c^rtification 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: / f / �) . ) I
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 Ao-tha_
proposed -work ,
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141
Applicant's signature
CAMA Official's signature
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Issuing date l
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .02b3