HomeMy WebLinkAboutMichael Rogers (2)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 7K46pil or NCGS 113A-103 (5) (b) (5)
Applicant Name T+ CU4Q( ti'/f Phone Number91/1
Address ` 1-V DG� 0'f li ;
City 1> c_ V1 JrJ State ter Zip -z �- 3
Project Lotion (County, State Road, Water Body, etc.) v v n �v �a r C_
c., .-2&tk(, '1
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 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 is signature
CAMA icial's signature
Issuing date Expiration Date
3/23/2020
Mail - Brock, Brendan O - Outlook
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*03 or NCGS 113A-103 (5) (b) (5),
ApplicantName �i11 c,(k0k T-00,A _Phone Number Ito Ltl.0 7'�kv
Address 1-1�V
City "0.¢)t-V J1rJ State NZ Zip z1 3
ProjectLo tion(County, State Road, Water Body. etc.)
t 2 Cs'i6 't _---
Type and Dimt nsigns of Pr ect
The proposed profectto be located and constructed as
described above is hereby caellified as exempt from the
LAMA permit requirements. This exemption to CAMA
permit requirements does not alleviate the neoessity 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
of 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 fur the
development
The applicant certifies by signing this exemption that the
applicant will abide by the conddions of this exemption.
APPII a 91R'
CAMA d1ficiars signature
3-0-13-'I—( 8-�.a
Issuing date Expiration Date
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3/23/2020
Mail - Brock, Brendan O - Outlook
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address: /��A/ 1,d-;MI
Phone Number:
Email Address: ArGIII�Grv:j'u-C &4g-" nt , 4�
I certify that I have authorized A�/r�� ��?a�G s
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining ail CA/f MA permits
necessary for the following proposed development: �-hs I►.�l �4"7 I�Z5Ael-
I t,-jrl Sul/c�4�a� 11
at my property located at
in K;iGK_County.
Z-V YeK
1 furthermore certify that / 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:
— —eE�.�r�
// Signat6re
Print or Type Name
Title
3 l/3124U
Date
This certification is valid through 31 i3 1 ---'
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