01653D - DeBell

CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT
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�,
flicant Name
Iress 51(
ie and Dimensions of Project
proposed project to be located and constructed as described
e is hereby certified as exempt from e CAMA permit
rement pursuant to 15 NCAC 7K ( . This exemption
6,MA permit requirements does not alleviate the necessity of
obtaining other State, Federal or Local authorization.
Ila
This certification of exemption from requiring a CAMA p
valid for 90 days from the date of issuance. Following exp
a re-examination of the project and project site may be ne
to continue this certification.
,ETCH (SCALE:
3
b6ff6,L
V I A

I F. Easley, Governor
to obtain any
A7jA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Charles S. Jones, Director
Authorized Agent Consent Agreement
William G. Ross Jr.. Secri
GU i!141r t is hereby authorized to act on my behalf
( Printed Name of Agent)
k permit(s) required for the property listed below. The authorization is limited to th
: activities described in the attached sketch.
'10NzF`,L CT:
r v se �P��1 ��
:RTY OWNER MAILING ADDRESS:
PHONE NO. 705 — qQ & - 6 7 q
PRIZED AGENT MAILING ADDRESS:
PHONE NO. Cl 16 " 4 q3 _ 90rt�.5-
-e of Prnnertv Owner k�--L G&

16 'aS- I S