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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.
cant Name ; t (,,/ril % cc Phone Number
ess %O t Gat � td 02,Hae
7 0" Mate r c up i.
act Location (County, State Road, Water Bo d, etc.) 2 % L a i S 9dQ, Ad. �< 7U �/ww
P41 ✓,t,r
and Dimensions of Project
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
4 permit requirements does not alleviate the necessity of
)btaining any other State, Federal, or Local authorization.
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This certification of exemption from requiring a CAMA pert
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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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross J
Authorized Agent Consent Agreement
(Panted Name of Agent) is hereby authorized to act on my I
in order to obtain any CAMA permit(s) required for the property listed below. The authorization is limite
specific activities described in the attached sketch.
LOCATION OF PROJECT:
Be 9!:4 A/
PROPERTY OWNER MAILING ADDRESS:
N 0 R.T C K('o L.r, Uj PHONE NO." "' `l� `0
AUTHORIZED AGENT MAILING ADDRESS:
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PHONE NO. 3R0—
Signature of Property Owner:
Sinnah ira nT Ai ithnri-7cri Lnnnt•