General Permits (417)

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-,I,
CERTIFICATION OF EXEMPTI
FROM REQUIRING A CAMA PERMITI�
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 w-�
Address 1 C J Dor.wo o C�
City R I r
Type and Dimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15r NCAC 7K .0203. This exemption to
CAMA permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local authorization.
State
7P r,
N 12 1993
M5�i 61V L r
Phone Number
Zip
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: )
e
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.
7
Applicant's signature
CAMA Official's signature
Issuing date
Expiration date
Attachment: 1$,,North Carolina Administrative Code 7K .0203

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ILIA/NSWICK COVNTY, NORTH CAROLINA
1. PATRICK A. ALLEN, CERTIFY THAT TIIIS
MAP WAS DRAWN FROM AN ACTUAL SURVEY
MAD► fY ME, THAT T/lE ERROR OF CLOSURE
AS CALCULATED MY LATITUDE AND DEPARTURES
IS, . J�70 THAT IT WAS DNA WN IN
ACCORUAN�E WITH C.S 4F-10 ASAMEND£D,
AND TIIAT IT IS TRUE AND CORRECT TO TILE
1t5T OF MY KNOWLEDGE AND 11E1-1EI.
WIT NE MY NAND AND SEAL, THIS THE
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BRUNSWICK COUNTY, NORTH CARDONA
I A NOTARY PUBLIC OF THE COUNTY AND STATE
AFORESAID. CERTIFY THAT
A RECISTEAU LAhD!PERS004ALLY
APPEARED BEFORE ME THIS DAY AND
ACKNOWLEDGED THE EXECUTION OF THE
FORECOINC INSTRUMENT,
WITNESS MY NAND AND OFFICIAL STAMP OF
SEAL,
TIOS DAY OF _a
NOTAR i
MY COMMISSION EXPIRES;
FLOOD ZONE A.13
MAP CAB.L PG. 31
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NORTH }SHORE DR.
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NOTE:
AVERACE LOT ELEVATION AT STREET RIGHT OF WAY IS FT. M.S.L.
SURVEY FOR
YARBROUGH FARR CONSTRUCTION
LOT 14 BLOCK 40-C SECTION SUBDIVISION SUNSET $EACH
SHALLOTTE TOWNSHIP BRUNSWICK COUNTY, NORTH CAROLINA
DATE 4-22-91 ALLEN SURVEYING SCALE 1"-30'
PATRICK A. ALLEN SHALLOTTE, N.C. 28459
FILE NO.
REGISTERED LAND SURVEYOR