Lawrence (2)

CERTIFICATION OF EXEMPTION
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---_____-- FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
0 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.
licant Name St,,8$gAi 1-i94.J"L°-ce �G 6a,c e e, , /4,„ i,- Phone Number4-0)3d7-.
ress 5&2, i t„iFruc,c 29N .e
- /l h/,l 1 State J C Zip 25;
ect Location County, State Road, Water Body, etc.) �//D sT. /1 ,',4 L, 7 0 079,
and Dimensions of Project &e 2 - e ii e -Er,cfe1 t ,)o, oim to", /4.2. �.•( •S,1,f
a LkA '9 J ..S')a9,3 fob-, e,, lied 0,0�.
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA pc
,e is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expi
)ment pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nec
IA permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
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North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S.Jones, Director William G. Ross Jr
Authorized Agent Consent Agreement
>r e \'�
C'DrN \�.�.-� (\ is hereby authorized to act on my bE
(Printed Name of Agent)
order to obtain any CAMA permit(s) required for the property listed below. The authorization is limited
ieciric activities described in the attached sketch.
)CATION OF PROJECT:
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ZOPERTY OWNER MAILING ADDRESS:
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JTHORIZED AGENT MAILING ADDRESS:
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