General Permits (4798)

CERTIFICATION O EMPT101 C�
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FROM REQUIRING A CAMA PERMI]AN 0 2 1992
as authorized by the State of North Carolina, _
Department of Natural Resources and Community Inpnlenfaad ttae sources Commission
in an area of environmental concern pursuant to 15.1CAGSubchapter_7K_Q�. m
Applicant Name 4-n �jc_k L i Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.) —7
Type and Dimensions of Pro)ect �
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.
Wily F ci i� .•�� rev.....,..., .. �.�� .. ..........r..._.._ ......__. __..
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.
This certification of exemption from requiring a CAMA permit is
valid for 60 days from the date of issuance. Following expiration,
a re-examination of the project and project site may be necessary
to continue this certification.
Applicant's signature
CAMA Official's signature
11 0
Issuing date
1. ') - t V , (1
piration date
Attachment: 15 North Carolina Administrative Code 7K .0203