02117D - Westbrook

CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA 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 .0103
licant Name
icat�n (Co nty, State Rod, Water Body,
v.� . t t 1(a (.t ✓� �" �.
and Dimensions of Project
proposed project to be located and constructed as described
e is hereby certified as exempt from the CAMA permit
Arement pursuant to 15 NCAC 7K . C?I G� . This exemption
:AMA permit requirements does not alleviate the necessity of
r obtaining other State, Federal or Local authorization.
02
Phone Number
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This certification of exemption from requiring a CAMA
valid for 90 days from the date of issuance. Following e)
a re-examination of the project and project site may be i
to continue this certification.
KETCH (SCALE: ' _ a i
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59
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North Carojina ,
4 Department of EnVITO
'ev" C-aw's Perdue Division Of Cow.ta,
nment and Natjjral
GOvernor 'WMNement
H ""kegm)
DiMM'for
&� �AqRqAa 0
Date:
game of prOOOM
Owner Applying for Permit:
� �,Iea
Atoss,
NMe Number.. LtLt)j yj
may that I have aUthCir1ZOd (agent)
""ff. for the purpose of
aPPlYing for and obtjWj terart on my
ng aR CAMA pen -nits necessary to irmtaij or
Onstruct
t f Z•-T
kmy Property located at) - --2--J lkA -T�
lis certification is valid thru (date) 2-
OPertY Owner Signalure
Dee Fr"m an
Secrelaty
Deft

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CERTIFICATE OF EXEMPTION
FROM REQUIRING A LAMA PERMIT N° 0;
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 7KK -0103 ,
Applicant Name (J- Phwe NUmbe q1b)2.2v1-
AddrQss__
City DAY1 State V Zip C
Pr jet Lvcat' n (Co nty, State Ro d, Water Bo y,11 ,�
Type and Dimensions of Project
The proposed project to be located and constructed as described This cerdflcation of exemption from requiring a CAMA
above is hereby cerdfled as exempt from the CAMA permit valid for 90 days from the date of Issuance. Following e
requirement pursuant to 15 NCAC 7K , 0 073. This exemption a re-examination of the project and project site may be
to CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining other State, Federal or Local authorization.
SKETCH (SCALE:
I
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