General Permits (2200)

CERTIFICATION OF
FROM REQUIRING A CAMA PE
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Re
in an area of environmental concern pursuant to 15
1
TSEP 1 5 1994
Commission
Applicant Name i 0 In f U a r d Phone Number �� `�� " 6 9
Address r rl P kzd
City 1 n a r ; State zip
Pro' t L on (Cou*, State Road, Water Body, etc.) N to V,- �� n 1 l v= n ( P
/ VV r
Type and Dimensigns of
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.
r -r'a
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.
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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
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.
Applic ets signature
," 0 .
CAMA 9>ff�'al's nature
Issuing date ( [,
Expiration date V/t- ' 0 0r� ,1 o�� tJ fiGL
Attachment: 15 North Carolina Administrative Code 7K .0203