General Permits (6865)

O
CERTIFICATION OF EXE
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
Applicant Name <'r" ,- �f! l L,f e k')f I oti{kikrk�u .r ��r�j SJ J�
Address rJ-
City ? State ,4V C , Zip D& %' S
Project Location (County, State Road, Water Body, etc.) ra rJ ,�l'r'` dirt ( /rvn<
Type and Dimensions of Project
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.
- ,,
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.
'` f l
Issuing date. V J
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 ''. ' ou
landowners certifying that they have no objections to the Expiration date
proposed work.
Attachment: 15 North Carolina Administrative Code 7K .0203