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CERTIFICATION OF EXEMPTION ts
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 29,<1/ u j7Q t O,4 / R"4,ft f /Y a Ici d Phone Number 9/tl>
ess .r. _Uo T, S # /qi/t
, State /j/ ( Zip ,2 tr.
:ct Lo�atfon(County, State Road, Water Body, etc.) rAI 1) of dl
14Ai c ✓1irAC'o/9s/2 1-.40 e a_ f Nest S5 �a ✓ ��Lyrfr_✓.�e(�
and Dimensions of Project R e -$w,, 'e/lt 0. / c + c��� BG l f Ri# p ct leer L4 c e
C. - ,s,�,�� RNLX e9d.
roposed project to be located and constructed as described This certification of exemption from requiring a CAMA per
is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expir
-rent pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nece
4 permit requirements does not alleviate the necessity of to continue this certification.
)btaining any other State, Federal,or Local authorization.
ETCH (SCALE:
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/06/2008 08:48 9108426413 CAROLINA CRAFTSMAN PAGE @1/0
46174,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F.Easley,Governor James H. Gregson,Director William G.Ross Jr., Secrf
Authorized Agent Consent Agreement
6 (170 6�i `5.M a$// ItV/60(9trAkittoMs hereby authorized to act on my behalf
(Prifed Name 6fAgent)
Drder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited to tr
ecific;activities described in the attached sketch.
CATION OF PROJECT:
24L___Vavfor? Nar caY' t diUtS
hro Sty
51441341 Ile
tOPERTY OWNER MAILING ADDRESS;
ct w yea�?on f OA .�
`250c cJ An Ave
3. pp bst 244 62.. PHONE NO_ ' 075` - 97y9
JTHORIZED AGENT MAILING ADDRESS:
V/liar,° r/71 i4h'lr,1a? ,<,rec
1 6 Leoriararld
PHONE N4, 97d 27,-26A
gnature of Property Owner: Ciet- fyu....eAg-MSlure t. itov' "'

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