General Permits (515)

CERTIFICATION OF EXEMPTION`
FROM REQUIRING A CAMA PERMIT t�7�"? ClcaVta �Q�2
as authorized by the State of North Carolina, � (A �� i�
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 Names ��� �� c� - =j t 6(-) \W Phone Number '�W 04,�F% » �i Vik
Address U) 0- S>Z VV : W1a
City "I* i- t `-, < ,, State Zip ;;� t (t ( —
Project Location (County, State Road, Water Body, etc.) (iN _ %�'� S�
Type and Dimensions of Project x
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.
SKETCH(,
C. r
44 ;
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.
This certification -of exemption from requiring a CAMA permit is
valid fir 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.
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CAMA Official's signature
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Issuing date
x uu �L, - - - -
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203