General Permits (872)

CERTIFICATION OF #
FROM REQUIRING A CAMA PE IVIf�Y U 7 2001 P L4 Lf f
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Res ur&9
~_'Wou ces Commission
in an area of environmental concern pursuant to 15
Applicant Name I�Y\ K U C ,c ;
Address I c '1'-E
City
Project Location (County, State Road, Water Body, etc.)
f u i i f Phone Number C:, a -20--
C' J State zip .2c a 1�
r L�w i C V_ ( u 4 to
MCI
Type -and Dimensions of Project
—firr("c
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.
n4-:4 UiA-+ 1,'
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.
I SKETCH (SCALE: KJ,, r --r; , ) I
K ik _ ill a, A /" � A-^ w 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.
Applican ,s signature r
CAMA Official's signature
_4- C
Issuing date
Is , t�
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203