General Permits (2382)

CERTIFICATION OF EX RVIPTION
FROM REQUIRING A CAMA PERMIT
SAY 0 9 It,
as authorized by the State of North Carolina,,.,
Department of Environment, Health, and Natural Resources andSba,Gp�,sta esc fission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K
Applicant Kin
o I h J- V, If(, -f-
Address O r r-t c
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City INNo, r i o .p)
Project Location (County State Road, Water Body, etc.) _
Type and Dimensions pf-Project orb r v c
l4ncAware 0 /�7arS
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.
Phone Number'\ a` 4��3`%Lj
State CD zi
r- ii�, firr VC 7- 1,1P' t
11
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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NMEEMENNEE0EN
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 s nature
,7',1,1,I . 0
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203