General Permits (940)

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CERTIFICATION OF
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EXEMPTION
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FROM REQUIRING A LAMA PERMIT
as authorized by the State of North Carolina, L.. ("o - '-►v" C
Department of Environment, Health, and Natural Resources and the Coastal
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K .0
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Applicant Name r Phone Number 'cZ3 . 4aa3 . 1)a\
Address_
City ':°c- State Zip
Projec5(t Location (County, State
Road, Water Body, etc.) !�echu
Type and Dimensions of Project %-) , - ", 4 X �� , •:., �,�A, .-.-;* a
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
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 oADDlic�nt's sture
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the -
development. CAMA Official's signature
The applicant certifies by signing this exemption that (1) the ap��'�'��
plicant has read and will abide by the conditions of this exemp-
Issuing date
tion, and (2) a written statement has been obtained from adjacent`+
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K .0203