General Permits (452)

CERTIFICATION OF EXEMPTI �"""
1293
FROM REQUIRING A CAMA PERMIT
�� ; i
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal RE sti5n'r U
in an area of environmental concern pursuant to 15 NCAC Subchapter
Applicant Name TA ivy E 5 A • L 4 N! �_ r Phone Number 0 03) G 4 3 - js
Address h hy S Y' 0
City v State ;' r^. Zip, Z Z 5 .&g
Project Location (County, State Road, Water Body, etc.)?��d& - I O t
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 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.
sent of a LAMA otticiai unaer the mistaKen assumPuUn uiai uid
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.
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.
/ ppill.alll J JKU. Ilaluly
CAMA Official's signature
Issuing date c
-t
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203