Wnding

CERTIFICATION OF EXEMPTION
-Y
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
r` __ in n area of environmental concern pursuant to 15 NCAC Subchapter 7K.0203.
(de."' 1
cant Name / i�G !',vei Pl�N49li°.�. 9e 57,,, H,,,7 they Phone Number /e)? 4 9 -/
ess2oo Ri I/94Aa.ct ,Q. S/' ,
Bpi, Ii,A State , Zip ,
act Location(County, State Road, Water Body, etcc..) 20 0 �Q,y/4 ,..rse .�IL . Sf' -, c, , ✓ 4,
'PG)GUr�3 'i, 4, ✓A.. ' ES.nv,�scr,CA- C 6u.r j.
and Dimensions of Project g eVor,2/o .v y/xle 4? 12 ' 2 #.SF c ,G N el Co'-cg,-/r ,Q/9 np f
iL , a -< J,r L/C 4, ' 44 ,.. 5#J M , ' Pci,)- .49,.6,17
roposed project to be located and constructed as described This certification of exemption from requiring a CAMA per
is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expir,
rent pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nece,
permit requirements does not alleviate the necessity of to continue this certification.
)btaining any other State, Federal, or Local authorization.
ITCH (SCALE:
.."\\ .
_i
1t /lac``11
2'i/!` /G
Z Z .�
cx,.,,,,c3,,71 x..;.,- -i-r-_, /9/zo,0 7ec,„..?;'') \e- N----
1 ,fie 9,4,ed
"a2L1 6,r(/L e/s , ? u.S 1gp /a ),eed ,iav �.
N
/vU %144 Co.v</leIf /`}/4wQd /n/ c✓A.1P227u1,,

Altai
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue,Governor James H. Gregson, Director Dee Freeman,Secretary
Date g S b Q
Name of Property Owner Applying for Permit:
W�10-7-A1 /C�J ! C.14n1Tft i Lp.J
Mailing Address: (Pijv`S
)00 41d Eftlio vl SE f SE /G 3 e ivai-r A KY C. L eoA
60 Lz✓D4 Arc- Z (2-1- L.1-►t.v VIA N �I �-
I certify that I have authorized (agent):En,. gclnitOCE`/ 4.1A47tK Lt.AiE. to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct(activity) ik E/AI fZ 6o /E4 0 AT- CO 4 a--14,14 P ,
at (my property located at) 1 Db `(z(1E/C-►71o(AS 6 0 R , ! SF
This certification is valid thru (date) /2/3 t 1 c
8 I7 4

I L 1 I 710
`5' I
v, i
t° 73.8A-r
I-- 0 RV4,:.<
-xi.of
PI
T "�► ---7 E srr,JG Ur-lo1(--
Ill
I 4P L'A 21-' 4.)44.c. 'Ta 66 RFaie
' EGT?o eA I OCAE h IE4rLurc6.
-; E Cu-1- 74-
4 PGAcE9
I
1-1-71
27-' S.&-r.ro,J '7z Q
\l/ g.Fet-4-ci
(Ai rN0.-AiU fizwi2 Pc4p4-;i
-100 R-xveiCk4aticE ( 0, S6