General Permits (3128)

CERTIFICATION OF
FROM REQUIRING A CAMA PERM T SEP 11 �99G
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resour ommission
in an area of environmental concern pursuant to 15 NCAC�,igtQx.'•IF"""'�
Applicant Name C i\,+V&cPO Phone Number '�"\c1
Address 11r14-1 0-"A\,_o P_Sec k ( lJQS\
City \-ihc��r State NC. Zip Z�(U—
Project Location_(�County, State Road, Water Body, etc.) �ecvh- C,a °\l�0 a�s•.��c+� d�
Type and Dimensions of Project C,5 `� k ` �� t �•..
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.
This c(-rtification 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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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.
A ticariMignature
CAM -A Official's signature
40 � wu '�
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Cody 7K'.0203