General Permits (225)

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CERTIFICATION OF EXEMPTI
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal I
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .02
Applicant Name Al
Address
City <_e ; , .�� , A
Project Location (County, State Road, Water Body, etc.)
Type and Dimensions of Project
W i pj AS ! 2l X l 2, Q (L�_Tr�
The proposed project to be located andconstructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. 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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SKETCH ;,/&;
State
N r2464
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Phone Number —;
zip a_-
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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ly
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. x _4_.I..::-;L. 1-, i
nt's
Al C.
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CAMA Official's signature
Issuing date
' �_
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203
4L.