Dr. Franklin Clark

• CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environmental Quality and the Coastal Resources Commission in an area of
environmental concern pursuant to 15 NCAC Subchapter 7K or NCGS 113A-103 (5) (b) (5)
Applicant Named r /Y�''1�L�''� L��� ''" Cd oc�% Phone Number
Address / l o_lyox
City ey;//F State %U C zip
Project Location (Count ,StateRoad,WaterBod ,etc.) 12/0
>/4'f�^'h'f ij,n,,�i✓t(� L✓K'iC/TS V/Ll� Ft/1961A, /V L
Type and Dimensions of Proje K ' FT 7
The proposed project to be located and constructed as
described above is hereby certified as exempt from the
CAMA permit requirements. 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 120 days from the date of issuance. Following
expiration, a re-examination of the project and project site may
be necessary to continue this certification.
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Any person who proceeds with a development without the con-
sent of a CAMA official under mistaken assumption that the Applicant s Sig ture
development is exempted, will be in violation of the CAMA if there n�
b t d t ' t' th
Is a su sequen a ermina ion at a permit was required for the
development. CAMA ffic' I's signature
The applicant certifies by signing this exemption that the -T7
-711,9
applicant will abide by the conditions of this exemption. I uing date E iration Date

5140
MAR 2 0 20
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION --- - ---- - - -- - -
Name of Property Owner Requesting Permit: f,�h •/►�►�'�1n
Mailing Address: Pd T—S D 4—
Phone Number: R1 D' Pg ` loq l 9
Email Address: h�?wi(. fit) QNti��W
I certify that I have authorized ` L n c. r� /"'t `-'" "�ow
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: lnm ow-L`n
r4ww ti�NL 5�T>w► L�sT j I ►fAO»> P
at my property located at dI b WSt 1 lJ►u�l+lf3Lr}l4 iJr U 7,9g6�
in &dWi,- County.
I furthermore certify that i am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
" Signature \
�iLrl�lzli� U�
Print or Type Name
QLJKU►v
Title
Date
This certification is valid through 3 1 11 1 22
f & YA" �i 'f&W av, 1410,
PO. Box 866
Wrightsville Beach, NC 28480
[phone]
0A &"
�vit�•

Dr. Franklin Clark, 210 Watetr St., Wrightsville Beach, N. C. 2"80
Replace outer Vx2V floating dock section lost in Hwicene Fkxence. N ft"t 2,011
V
FsS Marine Contractors, Inc.
Complete Marine Construction Services
For Over 40 years!
CAPT. ED FLYNN DURWOOD SYKE
Piers, Floating Docks, Pilings, Bulkheads,
Boat Lifts, House Pilings, Repairs
P.O. Box 868 Phone/Fax: [phone]
Wrightsville Beach, NC 28480 email: [e-mail]
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