02135D - Hites

CERTIFICATE OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resource's Commissior
in an area of environmental concern pursuant to 15 NCAC S bc1h/apter 7K,U103 ,
all '! KAr1 _H,its e-�4 6 (1,,, Phone Number
le and Dimensions of Project
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 1 f: A . This exemption
kMA permit requirements does not alleviate the necessity of
obtaining other State, Federal or Local authorization.
021
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: ; ZO
i
�ts�tvrU��p

CERTIFICATE OF EXEMPTION
FROM REQUIRING A CAMA PERMIT N° 02
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resources Commission
In an area of environmental concem pursuant to 15 NCAC Sy4chapter 7K. 103
proposed project to be located and constructed as described
,e is hereby certified as exempt fr m the CAMA permit
irementpursuant 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 f
valid for 90 days_from the date of Issuance. Following exi
a re-examination of the project and project site may be n
to continue this certification.
(ETCH I (SCALE: I ii_ LLB
� laced o�-
vv� ,

t4-2�7
-vj
f j I

11�9 Nick ��n+�4.

V
•�
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
,erly Eaves Perdue Braxton C. Davis
ternor Director
Dee Freemai
Secretar
AGENT AUTHORIZATION FORM
Date:
e of Property Owner Applying for Permit: Nameto Aut r' a Agent for this roject:
AD,r ' ,cs �3�1
.r's Mailing Address:
7 t e 'Alt
'OLO(er✓
e NumberffiD $h4-Z-3304
Agent's Mailing Address:
r V a
■'� - XA
Phone Number
fy that I have authorized the agent listed above to act on my behalf, for the purpose of applying
�d obtaining all CAMA Permits necessary to install or construct the following (activity):
2C7F • j
ty property located at
.ertification is valid thru (date)
4i'l
-
i� ?-Zo1Z
operty Owner Signature Date