02281D - Rice

CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT 024
as authorized by the State of North Carolina, Department of Environment and Natural Resources and the Coastal Resource missio03)383
in an area of environmental concern pursuant to 15 NCAC Subchapter 71(. e1
,Iicant
ject
e and Dimensions of Project
)roposed project to be located and constructed as described This certification of exemption from requiring a CAMA pi
e is hereby certified as exempt from the CAMA permit valid for 90 days from the date of issuance. Following exp
rement pursuant to 15 NCAC 7K, 0163 . This exemption a re-examination of the project and project site may be ne
kMA permit requirements does not alleviate the necessity of to continue this certification.
obtaining other State, Federal or Local authorization.
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/11/2013 14:25 9107544290 OFFICE DEPOT PAGE
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F _asfey, Governor James H. Gregson, Director William G. Ross Ji
Authorized Agent Consent Agreement
h—L11IN1m1Ic KJCRJ-- J:: aU is hereby authorized to act cn my t
(Printed Name Of Agent)
order to obtain any CAMA permit(s) required for the property listed below. The authorization is limiter
)ecific activities described in the attached sketch.
DCATION OF PROJECT.
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ROPERTY OWNER MAILING ADDRESS:
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P H 0 N E N0 y7 1 -05D--?U
JTHORIZED AGENT MAILING ADDRESS:
V/ C• PHONE NO. 916-23 YY13�
3nature of Property Owner �(/

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