Harvin

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
k 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.
dicant Name .57evv 11A1Z vim % 0, It 7/pn„4 r
Iress
o State
'sect Lo ation (Count/Y, State Road, Water Body,/etc.) l „,-
1.
e and Dimensions of Project
'�-1.jr c,
proposed project to be located and constructed as described
,e 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.
Phone Number
14 Zip
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This certification of exemption from requiring a CAMA pe
valid for 90 days from the date of issuance. Following expl
a re-examination of the project and project site may be nec
to continue this certification.
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MWR
North Carolina Department oI 6vironment and Natu ui Resource
"Msion of Coastal Mar~aaerrreni
B.everiv caves Perdue ,lanes H. Gregson i?ee tree na!
,ap„nor L�;rector Secretary
AGENT AUTHORIZATION FORM
Date:,
Name of Property Omer Applying for Permit: Name of Authorized Agent for this project:
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:;caner �s iiatiin� :address:
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,..- z 7-1- 19dY
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