01205D - Reaser

icant Name
'ess 7
CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT
012
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K , 010 Ix
Glt� :G VV Phone Number
Zip
;ct Locatiori (County, State Road, Water Body, etc.) CinAA E�4
and Dimensions of Project
. ; i. i.-r ,.. n
roposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit
ement pursuant to 15 NCAC 7K 'I �,-1 . This exemption
.MA permit requirements does not alleviate the necessity of
)btaining other State, Federal or Local authorization.
This certification of exemption from requiring a CAMA pe
valid for 90 days from the date of issuance. Following exph
a re-examination of the project and project site may be ne(
to continue this certification.
-TCH (SCALE: Z0,
�` � _ P11?,f>✓tJ� . � 1.
4 4
N
off' 4.- u1a✓K
C�V "h fMZAh ah. �
I' rSjA4 fv<� <,act Wr Jr
l��cs Not a o y EI

AtQ,F,N.r A!lLfogyArtkyN l c� r�� r"� [ tVT �44 t 1�t?ATION EC �
Narive of Property Owner AWyuV for Pw and
this proje,-t
Nam of Auftortzed Aptt kw
tlwgor % Mading .AddrM Apent's Ma. ing 4-1draw
Phome Nwrt'aer ,_, fir' _ � (�a Phone Number f`_ j '� , ? 1
t falfoy mM I have "tno qed ne apnt listed above to act on my buff. for the purpow
of app"
for ard obt ain ng at CAMA Perntvts rw.*sury to mstaH or constnxi tiv kr k w ng
tact y,,,Y j

4 'Jsjej� .3xs"
X1 pAirg
t-f4A-'f*,-*n
mmsw8 IeAWN fx* WOw4 k,,13 P wvA*0)0 eu4wPO 4W*
Ems) riAl; Pelt-A"N UNY"
le polr:oov Apedoid Auj job

J
r