01794D - Perfetti

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CERTI FICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT 01 i
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 _ . ( i, �g l �11�� _1�5
dicant Name
ress ; tL
e and Dimensions of Project
)roposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit
rement pursuant to 15 NCAC 7K , i , . This exemption
kMA permit requirements does not alleviate the necessity of
obtaining other State, Federal or Local authorization.
VY X
This certification of exemption from requiring a CAMA pE
valid for 90 days from the date of issuance. Following expl
a re-examination of the project and project site may be ne
to continue this certification.
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NCDM
North Carolina Department of EnviOnment wd Natural Resources
©ivision of Coasu Ailanagear I
Eaves PerdW James H. GieW
Govemor DOWN
Dee Fa
Sec
AGENT AUTHORIZATIQN FORM
Date: — 97�Z—1 �(
Nam of Property Owner Applying l' Permit: Name of j A4eatfor this project:
Y#, 4i
LS.-
OwrWs Afa"g Address: Agent's A4�irg Address:
o
Phone Number -4 -� �' G Phone Number (YIV) YY 3 —
I certify I have authorized the agent listed above to ad on my gaff, for the purpose of applying
for and obtaining all CAMA Permits necessary to instate or construct the fbilowing (activity):
(my Property se
This ceatificatlon is void thru (date) 7
Property Owner signature 1]ate
RECEIVED
DCM WILMINGTON, NC
0 C T 0 6 2014