General Permits (5891)

-Y
CERTIFICATION OF
FROM REQUIRING A CAMA PE
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Re
in an area of environmental concern pursuant to 15
Applicant Name -�t .Y—i-;istI- / ,l _6
Address ?s'"i i,i
City
Project Location (County, State Road, Water Body, etc.)ss.L.
yam% i s,\1 �1LQ,) ({y-tM,_7x tV_ rCUA
Type and Dimensions of Project !Z'X! 4- 001
6
X.:
ITO19%
n
ces Commission
Phone Number
_ State Zip
1 e A r fC
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 CAMA permit re- valid for g0 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 requirements does not alleviate the necessity of /- to continue this certification. _
your obtaining any other State, Federal, or Local authorization. �. -L. tk lwr
sent of a CAMA official under the mistaKen assumption tnat 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.
Appncants signature'
CAMA Official's signature
r
Issuing date
2/
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203