HomeMy WebLinkAboutGary BrownCERTIFICATION 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 71<44c& or NCGS 113A-103 (5) (b) (5)
Applicant Name t�.
Address 72 4 1 L
Phone Number -536 "� Y,Ky
City State N Zip 2 - 3 Sg
Project Location (County, StatA Road, Water Body, etc.) -
Type and Dimensions of Pro'ect ^
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
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 the
applicant will abide by the conditions of this exemption.
Applic signature
CAMA Official's signature
2.,--1 1 __102-C,) -7 - 18-2-074)
Issuing date Expiration Date
3/23/2020
Mail - Brock, Brendan O - Outlook
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by ft Sta m of NorM Carolina.
Deparpnent of ErwftnmanW Quality and the Coastal Resources Coerlliasion In on area of
envitorm ental concern pursuant to 15 NCAC Subchapter 7K4ftZ or NCt:9S 113A.100 (5) (b) t5j=
Applicant Name -b1 lam•► Phone Number 3X ".ry=
Address SZ 44 _ 6
City 5,,.,.{„C- k State N zip Z' s8
ProjectLoclr' (County Ste R ,Wate—Wy,g etc.)
Type and Dimensions d Project- tip.
The proposed project to be loafed and constructed as This csrtlfialbn of exemption from mqui ft a CAMA permft
daeoribad above is Hereby c@rK*d as exempt bwn the is valid for 120 days from the deb of iasuarme. FokwAng
CAMA penal Iequ iri ments. This oxwTq* n to CAMA expratlon. a rotxenllnalanoHha proJactarld projectaite may
pandit Iequiremunla doaa not alleviate the necessity of be necessary to continue this osrtl0ation.
your obtaining any outer state. Federal. or Loose
aut1wri:stion.
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Any person who proceeds w M a de"s op wit withoW the con-
sent of a CAMA ofRcfal under saetabn sswmWdw Thal ft
developmaM is exempted, will be in vial~ of to CAMA a there
is a subsequent determination Mat a par" was "Wed for His
TM spplkwd cwtdkm by signing this exemption Mat the
sppocanf will abide by the conditions of this exemption.
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CAMA Offtlsrs signature
-iq 1aki IT- 1a-2.0Zo
issuing dab Expiration pate
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3/23/2020
Mail - Brock, Brendan O - Outlook
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: cfll� /Drown
Mailing Address:
Phone Number:b
Email Address:
I certify that I have authorized 1�l IkdrriaS C1��tf711-oG9��?�y'
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:~/
-<:� 5'e' . 6e� Z/r,/ Etc/K"lce
at my property located at
in QR.u►sWfCJ- County.
1 furthermore certify that 1 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.
Property Owner Information:
■
Signature
Print or Type Name
Title
Date
This certification is valid through 3 1 1 2 i
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