01505D - Bennett

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CERTIFICATE OF EXEMPTION
FROM REQUIRING A CAMA PERMIT 01f
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resource o mission
in an area of environmental concern pursuant to 15 NCAC Subchapter 7K ` H /_33 62
C Phone Number U1 C
licant a e ( '
re
S to Zip
�c ttionA&nty, `State Road, Water Body, etc.) + o
and Dimensions of Project I
iroposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit
-ement pursuant to 15 NCAC 7K . This exemption
AMA permit requirements does not alleviate the necessity of
obtaining 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 expi
a re-examination of the project and project site may be ne,
to continue this certification.
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvaria, III
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: 10/27/2015
ame of Property Owner Applying for Permit: Name of Authorized Agent for this project:
ernon Bennett
wner's Mailing Address:
l27 West Henderson Street
disburv, NC 28144
,ione Number [phone]
Grice Construction
Agent's Mailing Address:
6618 Beach Drive, SW
Ocean Isle Beach, NC 28469
Phone Number
;ertify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
r and obtaining all CAMA Permits necessary to install or construct the following (activity):
)ulkhead
)r my property located at 1415 Bay Street, Sunset Beach, NC
its certification is v;Signature
u (date)
9
Property
10/27/2015
Date

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