General Permits (3903)

CERTIFICATION OF EX
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources
in an area of environmental concern pursuant to 15 NCAC Si
Applicant Name
Address
City
Project Locatior
riRbzTIA-bA
4 6 1996 Do
ice, ' O
A'GEMENT
Phone Number 3Qf� C
Type and Dimensions of Project ! - ' �—y"
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 CAkMA 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 requirerdents does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
SKETCH C (SCALE:
+ )
A
f IC Crt.1 -17C - — f v
EP
Any person who proceeds with a development without the con-
sent of a CAMA official under the mistaken assumption that the Appli 's signatu'
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development. CA is al' i riature
C G
The applicant certifies ¢y signing this exemption that (1) the ap- Tssuing'dt e
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 Expirat on date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K .0203

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ID: JUL 24'96 9:12 No.003 P.02
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