General Permits (5067)

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CERTIFICATION OF EXEMPTIO .'
FROM REQUIRING A CAMA PERMIT JUL 0 8 1997
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Co4s2a! Reso ._
in an area of environmental concern pursuant to 15 NCAC Subchapt 7K p!.Re
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Applicant Name C-�cr r r c r�C OA Phone Number +
Address a r- i , r + v r
City �- ! i -_, E? o .-: � i^ State &2 Zip 6
Project Location (County, State Road, Water Body, etc.) f2,Aivr r. r c, �, n.ti Aq cA f
�rJims,K,,c- k
Typeartd Dimensions of Project _.L` n , ,f r, �c.�' `J 1 /a-1 _ '�" �� l r,X rc1 a f" 1� � =1' x c e f
z .i,.�-- «Iu-yfr^.—I- \ t}��„— h u e..0 u. t !{ _.- rID 1«fr1.
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.
R, L C I .I
-� 1 t1 iA c�
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.
I SKETCH (SCALE: N, - t o Sri, // )
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.
ature
Issuing date
o2
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203