02103D - Gales

CERTIFICATE OF EXEMPTION �
"~ FROM REQUIRING A LAMA PERMIT �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 concern pursuant to 15 NCAC Subchapter 7K
Dplicant Name Non w{ s .t^ K M ur IA� Phone Number
Jdres 2
ty tate P2 Zip 2 =
.oject Location (Cour)ty, State Road, Water,Body j c.) ►�
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA I
)ve is hereby certified as exempt from the CAMA permit valid for 9Q_days from the date of issuance. Following ex
uirement pursuant to 15 NCAC 71(, Ir'-' . This exemption a re-examination of the project and project site may be n
:AMA permit requirements does not alleviate the necessity of to continue this certification.
it obtaining other State, Federal or Local authorization.
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Michael F. Easley, Govemor
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
James H. Gregson, Director William G. Ross
Authorized Agent Consent Agreement
hereby authorized to act on my
(Panted Name of Ag6nt)
order to obtain any CAMA permit(s) required for the property listed below. The authorization is limit
)ecific activities described in the 'attached sketch.
DCATION OF PROJECT:
ROPERTY OWNER MAILING ADDRESS:
✓� /Q Ill D AJ C-r C C--`5 PHONE NO. _ K. l -- 6 .7-i - 3 z :� Z
WTHORIZED AGENT MAILING ADDRESS:
PHONE NO.
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