General Permits (2343)

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CERTIFICATION OF E .L � f� f �n
�- J U L 2 6 �9�5 J
FROM REQUIRING A CAMA PERMI r
as authorized by the State of North Carolina, - Department of Environment, Health, and Natural Resource a esources ommission
in an area of environmental concern pursuant to 15 NCAC ! Mti�'.
Applicant Name W •\V aN. W (a.ti Phone Number �ti `��d 3bto3
Address �'-y
City \\. 11\-r; State Zip I-Y61�—
Project Loca ion (County, State Road, Water Body, etc.) v s1
lcut
Type and Dimensions of Project c- c, - k \ ' s
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. O
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: '' )
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TI
N oT i
1
L 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
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203