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-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.
cant Name Kv K T }t Phone Number `f I 44.E
ess c
State I Zip —_�4
!ct Location (County, State Road, Water Body, etc. �I ST C k
)
t
and Dimensions of Project k:iU
roposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit re-
nent pursuant to 15 NCAC 7K .0203. This exemption to
1 permit requirements does not alleviate the necessity of
obtaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA pen
valid for 90 days from the date of issuance. Following expiry
a re-examination of the project and project site may be nece:
to continue this certification.
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American Fish Company
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P.O Box 11046
Southport. North Carolina 28461
Email: AFC03600®aol com
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INVOICE NO #
[phone]
[phone] i
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Micnaei = Eas�ey, Governor James H. Gregson, Director �t iiiam R;
Authorized Agent Consent Agreement
,4, hereby authorized tc act c"
" - (P,jnted Name of agent;
,n order to obtain any CAMA permit(s) required for the property listed below. The authorization is I+i
specific activities described in the attached sketch
LOCATION OF PROJECT:
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PROPERTY OWNER MAILING ADDRESS:
PHONE NO Cj JC)`NLJ1-fWo
AUTHORIZED AGENT MAILING ADDRESS:
PHONE NO. q[0-4j3-
Sicnature of Property Owner.