General Permits (426)

CERTIFICATION OF EXE F�fIoN 5
�- 5 1993
FROM REQUIRING A CAMA PERMIT LE;
as authorized by the State of North Carolina, ' j ful-25
Department of Environment, Health, and Natural Resources and tR s. cur lion
in an area of environmental concern pursuant to 15 NCAC Subchapter 71K .0203.
Applicant Name 1-7 Phone Number '41(f L •- 3Za-
Address f
City �— State zip ->"' 4
Project Location (County, State Road, Water Body, etc.) /0
Type and Dimensions of Project
The proposed project to be locatedand 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.
tr This'�ertification 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.
SKETCH (SCALE: / 1,"- y/ )
Mny NaiZ�un wiw Niucddub wnu a udvdwNnidni Wuiwui Uld wii-
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.
II vu r
Applicant's signature _
CAMA Official's signature
Issuing date
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203