General Permits (624)

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT~`�• �`���'�
as authorized by the State of North Carolina, MAY p 6 1999
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 Q. t\C.: Phone Number
Address
City State Zip t
Project` Location (County, State Road;,, Water Body, etc.) \�13
,�, ._�\C.; 1�\ter• ,,.�c.- tat 0%c. J
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 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.
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.
SKETCH (SCALE: )
N
rT
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
Issuing date
1v� C��<' t �. � c,
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203