General Permits (221)

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CEf_TIF[C-AT]C 1-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 pu suaat-to- A .
Applicant Name moo ,+/ — �� Phone Number 6117-.2/ 3V
Address 20 Lu i
City Z-21"k,149 Aba State zip
k Project Location ounty, State Road, Water Body, etc.) "
Type and Dimensions of Project
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The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement putsuaat1ct15_NCAG-7"M. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
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ISKETCH
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.
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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 no objections to the
proposed work.
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CAMA Official's signature
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Issuing date
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Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203