Davis

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 0i5 /G G'/tire 60,'S'7/dc�C%� . Phone Number
ass v Xto 2 ,l Aws C,,
'K4 t m4-, State /Z L Zip 2 %J
ct Location (County, State Road, Water Body, etc.) 92 i /;7/9& Li..1 Sr
N� L
and Dimensions of Project _SYQAf✓c
14PPdr
,oposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit re-
ient pursuant to 15 NCAC 7K .0203. This exemption to
k permit requirements does not alleviate the necessity of
btaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA perr
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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GRICE CCN PAGE 01
06/17/2010 16: 46 11
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Authortzed Age it Consent Agreemant
GLZ � ri-L C I-N is hereby authoda9d to act on my
�IMVA!,OjuzifAp" .
in order to obtaln any CAMA porMA(s) roquired for e property [Wed below, rho authorization is limit E
spqctc activfts described in-toatadvd *WcK
LOCATION OF PROJWT.,
F-h04vEfi"8r1f,%q9,WNER MAJUNG ADDR1953:
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PHONE NO.
6 L RMED AOINT AAMUNG ADDRESS:
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