02270D - Ocean

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CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT Y9 02o
as authorized by the State of North Carolina,
Department of Environment and Natural Resources and the Coastal Resources m„misslo
in an area of environmental concern pursuant to I5 NCAC Subchapter 7Ky LJ,
>licant Name
cress 4
(')e r
Val (Tf UU(P,f J�d, is YWa(,t el() Phone Number
ie and Dimensions of Project
proposed project to be located and constructed as described
e is hereby certified as exempt frq tjle CAMA permit
rement pursuant to 15 NCAC 7K , .1 C, 5 . This exemption
4,MA 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 exr
a re-examination of the project and project site may be nE
to continue this certification.
ETCH (SCALE:
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INS _IM
(L_- I (i, n �J 1 I'c
t,

Date-.
of Property Owner Applying for Permit,
5r's Mailing Address-,
I CII 'SA
e Number
fy that I have authorized the agent listed a
id obtaining all LAMA Permits necessary I
r
LY/
nt of Environment and Natural Resources
of (Coastal Management
Braxton C. Davis John E.
Director ", I
I Lei MO
Name of Authorized Agent for this project:
-3
Agent's Mailing Address:
GIJ
Phone Number LI"0_ '7'5,-1- Uoa�
)ove to act on my behalf, for the purpose of applying
i install or construct the following (activity)"
C
iy property located at � XI Y -t 0(\ -(- d - FF \(
'ertification is valid thru (date)
perty Owner Signature
1(7,1
Date
RECEIVED
DCM WILM11'JIGTON, NC

RECEIVED
DCM WILMINGTON, t
0 C T 1 6 2013

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