McDonald (2)

�-Y 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 We ixuJ I'JQ Phone Number
Iress 1,nwftz-K!- tyA 0 C T
State Zip
ject Location (County, State Road, Water Body, etc.)
, , a-+, , : , �) Q
t
e and Dimensions of Project i ;��i t r� - ' T rat i�nl r �,�� + rc ;J 4i i-rit rN t - i ,T1KJ
i
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.
This certification of exemption from requiring a CAMA pc
valid for 90 days from the date of issuance. Following exp
a re-examination of the project and project site may be nec
to continue this certification.
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue dames H. Grepw Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: _22-1 1 l .
Name of property Owner Applying for Permit: Name of Authorized Agent for this project;
owner's Mailing Address: agent's Hailing Address:
et�eVr I) e-- a g31 tie a H �s r e P -l�q
?hone Number r � � � q � g6 7 Phone Numbe.r { ft q en �
i ceridy that 1 have authorized the agent 'fisted above to act on my behaif, for the purpose of apptyir;G
`.or and obtaining all CAMA Permits, necessary to install or construct the following (activity;:
frr`v nrooerhe located a,,
Fnis cerirricarion is V2lid inru (dl?,8)