General Permits (503)

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CERTIFICATION OF EXEMPTION ----- N
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FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, ?
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0203.
Applicant Name 1� IC 1P C 1 �-` > - t2u��it? Phone Number
Address c; 2. 2 C_-
City �' .-^, t �= r' State Zip
Project Location (County, State F ad, Water Body, etc.) �'G of �,ITHs, , o ( 2-4 0, r-1 L', (v —=mod r I D,
Type and Dimensions of Project 1 it — C 2- ti ")t2J I C L c
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The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary j
CAMA permit requirements does not alleviate the necessity of to continue this certification. ;
your obtaining any other State, Federal, or Local authorization.
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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.
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CAMA Official's signature
2 - z b — 201)2,---
Issuing date
5 ZUJZ.
'L91 -
Expiration date
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KI U a -r H ----->,
Attachment: 15 North Carolina Administrative Code 7K .0203