General Permits (381)

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Applicant Name
Address 10
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0114.t'
CERTIFICATION OF EXEMPTION �l;.
0 C T 0 5 1993
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources" rlwf lcry----------------
in an area of environmental concern pursuant to 15 NCAC Subchapter 714_0203.
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F. �-� J lArf Y i C AL:." , )A Cobs Phone Number �4-.--fo�1 7 C,
Project Location (Cou
ti-1 , C_ State
State Road, Water Body, etc.) I
Type and Dimensions 0 Project t "' 14 LAJ
'. 1. l 14-1 1 ,T .Af
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 .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
Zip - 716
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.
I SKETCH (SCALE: ( = �2Ci 1 ) 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 to the
proposed work.
Applicant's signature
CAMA Official's/signature
-s1l/1:13
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203