02110D - Buccaneer

Aicant Name V�
cress
ject Locate ion (Cc
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CERTIFICATE OF EXEMPTION /✓I6
FROM REQUIRING A CAMA 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 ,
, State Road, Water Body, etc.)
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State
021.
Phone Number 110. Z5i Sly
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Zip Z L(
ie and Dimensions of Project k� P.Dai ti 2 X l (i lc c, f i . fi
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proposed project to be located and constructed as described
e is hereby certified as exempt from the CAMA permit
rement pursuant to 15 NCAC 7K . This exemption
4LMA permit requirements does not alleviate the necessity of
obtaining other State, Federal or Local authorization.
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:
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Rc
Authorized Agent Consent Agreement
mlyax'ICc �t v�—f�L�/'-,Nf_ is hereby authorized to act cn r
(Panted Name of Agent)
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is lir
specific activities descd in the attached sketch.
IN S 40D oc,v,�6 /� e)C-" T
LOCATI� P�
PROPERTY OWNER MAILING ADDRESS:
n Or
PHONE NO.T O—a%"���
AU' HO/R/IZED AGENT MAILING ADDRESS:
�sJ PHONE NO.D"��' S7 3 Q
Signature of Praoerty 0wner: