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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 Th P17pa �v ke ( %% Phone Number!���
ress 0` Sex 2 (o 9
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ectLocation
y(County,, State Road, Water Body, etc.) / Z to.-.S f�ti. C f- o ih „.- 1JVjVo1&
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e and Dimensions of Project TRa4,,e 2 9 ' e(-I
proposed project to be located and constructed as described
le 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 expi
a re-examination of the project and project site may be nea
to continue this certification.
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North Carolina Department of Environment and Natural Resources
Civision of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Cloveritor
Di<ector Secretary
AGENT AUTHORIZATION FORM
Date:
Marne of Property Owner Applying for Permit: Name of Authorized Agent for this project:
;Dwners Mailing Address:
SA ex /o & - a 8Y
,Agent's iWaiftng Address:
2Cent ;ste EboN ?: syt vn �� hg?i?if ;�. in6 Urt�0�8 0= Epp:;' r
and obtaining all CA'N,A Permits necessar,' tJ instal! or--c-struct Isle folioyving (activiil,•'j:
(°�';:� ,�'� ��;+•r InCatvd` �a: _�„Z—,�¢G�/7 4 /G)!.✓ �.._�!F.�l._ �G� !J�`�
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