General Permits (4391)

O
Applicant
Address
City
Proiect Lc
Type
CERTIFICATION OF EN
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina, '
Department of Environment, Health, and Natural Resou*
in an area of environmental concern pursuant to 15 NCAT-M,
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.
JAN 0 7 1997
Commission
.f
Phone Number i� r Jt �r CY
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.
j SKETCH );' , - i` .f°AU L..-1:. PC►;` (SCALE: )
��.
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.
Appllea is signature'
CAMA Off icial'sisi�natur
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

•
4Oi
a
as - a5�2