General Permits (326)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT T 7, T T 71,
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Res&sogm
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0263.
Applicant Name /" Ir Phone Number / _ 8�
Address S
City r. 1?1 4ff, , State 4C Zipz') SO i
Project Location (County, State Road, Water Body, etc.) <Z
Type and Dimensis of Project
/Lo; 7 / � g/ r L�-u,
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The apose_�_project to be located and construc�eas 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.
a
his 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 ,P--. r. /'*3 % (SCALE: / r, , "-� / )
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.
�trtki�Y
R
nature
CAMA Official's signature
.S�
Issuing date
1D.f 9 _f
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203