General Permits (724)

CERTIFICATION OF E
FROM REQUIRING A CAMA PERM f
Auu p 1
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resournd th o es Commission
in an area of environmental concern pursuant to 15 NCA3 ENT
MOs�EN�Ab�' i i- i} r-f
Applicant Name t; �a►a--�— i-%t', Phone Number
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Address j ; ?. I �g i r�
City i' - State J Zip
Project Location (County, State Road, Water Body,�etc.)
Type and Dimensions of Project A n''
The proposed project to be located and constructed as described
above is hereby certified as exempt from the LAMA 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: )
t
i 1
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 L l
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

-Y-
ERTIFICATION OF EXE
MPTION
PTION
ROM REQUIRING A CAMA PER as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Res es and t e �tces Commission
in an area of environmental concern pursuant to 15 CAS t. r 7K .020/;f
�� L/ o Td
L2001 � �
Applicant Name S� O v ` Phone Number t U 25
Address 2
City u� 1 b�E T Zi
Project Location (County, State Road, Water Body, ta) p
Type and Dimensions of Project `n Irv. eXi S� n
The proposed project to be located and constructed as described This certification of exemption irom':re uirin .a CAMA ermrt is Y
9. 9 p
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of-is'vance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination offheproject and projectsite may'.be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.`
your obtaining any other State, Federal, or Local authorization.
SKETCH � SCALE:
ci T T
F t
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Any.person -,who:proceeds-with a development without Ake �on-
'sent ofa.CAMA:officiallbnder:the.mistaken.assumptionlhatlhe - Applica t'ssignature
-development' is:exempted,'::will be in violation.ofthe CAMA11here
is_a-subsequent'deierminationthat a permit -was Tequired-forthe
development. CAMA cial's:signature
The: -applicant tertifies°by signing this exemption that (1;) the .ap } JO A
.plicant has. read :and:will-abide by the.conditions,ofthis exemp-
Issuing date
tion,:and (2)a.written statement hasbeen obtainedfrom adjacent OO
landowners certifying •.that -they have no objections' -to 'the Expiration date '
proposed work.
Attachment: 15 North Carolina Administrative Code 7K-0203