HomeMy WebLinkAboutStephen Lovelace (3){ 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 7K4W7 or NCGS 113A-103 (5) (b) (5)
Applicant NameJ-YT
Address T -kp o
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City IA , N o�14_ State NC_- Zip S
Project Location (county, S( ( to Road, Water Body, etc.)
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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.
Applicant's signat re
CAMA Official's signature
3- i g -1_o z,0 • I 2oZ-o
Issuing date Expiration Date
3/23/2020
Mail - Brock, Brendan O - Outlook
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by uns Stem of North Carolina,
Deparbrrstnt of Erlvgorrrler" Quality and the Coastal Resources co -mission In on area of
envavrrnerttal mmem pureuartt to l5 NCAC Subdtapter 7KAol o► NCGS 113Ar103 (5) (b) (5L_-
Applicant Mame—'ft��"
• 0"Numher��
City ei� 1State IJL ZIP L 2 Ia
ProjectLocation ( c nty, 5fgte Road, Water Body, etc.) f ��"""� "� `' s� • '•"'
The proposed proodto be locsled and constructed as
dssI 1111 above is hemby certified as eaempt from the
CAMA permit requMamulb• This Sitertlplim to CAMA
parttlit requirMtlenb doss not aMvlals to neceasily of
your obtakft arty other Sues. Federal, or Local
sultlor zedon.
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This owtftaim of exemption from n quWq a CAMA po-*
is valid for 12D days Mom the date of tssuarlce. Fo/owklp
expiration, a ro-wmr -Abon d via projad and projed site may
be necessary to oonbnue ftds csrWiic r ion.
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Any Person who proceeds with a development without the con-
sent of a CAMA official under mistaken sawmptlon that the
deveopment Is sxempted, will be la vidallon of the CAMA It there
is a subsequent delernthwtlon that a permit ryas required for the
development.
The applicant certifies by signing this exemption that the
applicant will abide by the conditions of this exemption.
Applicant signet ��` A •l.J
CAr1AA olflciars signature
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Issuing dab Expiration Dat-
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3/23/2020
Mail - Brock, Brendan O - Outlook
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:�i{efr (rJU�/Gi!e
Mailing Address: 70 ,�l'�ii�5i X�
Phone Number: iO2
Email Address: 7%
I certify that I have authorized ,l '//! g41"GS //l 1 f i'�t
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /,VS A// S y<-X;"W
at my property located at ! 2 z_R,dz/1 i u.1!2 ST elf�-:��
in 6rt(A-ak 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.
Property Owner Information:
3i�n� re
Print or Type Name
Title
Date
This certification is valid through 3 1
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