Davidson

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
�\ in an area of environmental) concern pursuant to 15 NCAC Subchapter 7K .0203.
licant Name UCC Afu,dSc-�, to 0,4,r ej ewwecz, Phone Number
ress )// 4v. Dixie -Pa,
;y s I P k State i'v c Zip -2�"
ect Location (County, State Road, Water Body, eLtc.) /OS /--4, S �}j-,� 7 i9
�- S�T,g����"
0 and Dimensions of Project 4✓ koaf r �'�� .r,p,� oR P
j R, [ 41A oar/
proposed project to be located and constructed as described
re is hereby certified as exempt from the CAMA permit re-
?ment pursuant to 15 NCAC 7K .0203. This exemption to
1A permit requirements does not alleviate the necessity of
obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA pe
valid for 90 days from the date of issuance. Following expi
a re-examination of the project and project site may be neci
to continue this certification.
ETCH (SCALE:

PIL
Canat
Existing Dock << E E
105 HlghPolnt
New Deadm
PIL
Existing Dock
Area
107 HlghPoln

3 11 05:23p
Lee Davidson
3366265145
p.1
Beverly Eaves Perdue
Governor
—A71
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal_ Management
James H. Gregson
Director
AGENT AUTHORIZATION FORM
Date: l
Name of Property Owner Applying for Permit:
Mailing Address:
Dee Fre
Sec
Phone Nurhber: C!�� ) 4(PQ — t}
VUi er'e-cvti+e-
I certify that l have authorized (agent) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or
construct (activity)
at (my property located at)
This certification is valid thru (date) 41 \t>l a 0 1