Moore (3)

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.
Jlicant Name is)L N /12G or[ -c a orrt rs //. L do—, Phone Number a lyL -
Iress 70Z/12, 7),,
State /'' Zip
ject Location (County, State Road, Water Body, etc.) ,? 7 2 -/ d, . a . A o/�/.4 c e -,' ��'`a
Ad-e C/;rA! i {' /#/ i✓w /y`le,,,. �#0'4 c 4, cq.✓r t✓, CK, y
e and Dimensions of Project le c/l/9 c e C""x 'S 7"5 /-'tc 9 '.NS 71 o c /c.
proposed project to be located and constructed as described This certification of exemption from requiring a CAMA p(
✓e is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following exp
ament pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be nec
AA permit requirements does not alleviate the necessity of to continue this certification.
obtaining any other State, Federal,or Local authorization.
;ETCH (SCALE:
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
:hael F. Easley, Governor Charles S.Jones,Director William G. Ross Jr.,
Authorized Agent Consent Agreement
'431, 1.----_______
is hereby authorized to act on my be
G—AN-C\ I (Printed Name of Agent)
der to obtain any CAMA permit(s) required for the property listed below. The authorization is limited I
;ific activities described in the attached sketch.
:ATION OF PROJECT:
37 (A✓ A;14 dr- �' L it
IPERTY OWNER MAILING ADDRESS:
3 -7 ✓D© k(1., (i) r .
444/4 Ktici-i _ - s7v(toe. - ci ( D
PHONE NO. ,>j 4 —1 CP L
HORIZED AGENT MAILING ADDRESS:
02 S ,r_ d?ifIZ lc(
,,p17 AL 7/Stc. 2
PHONE NO. 9vo gc 2 Cj 9s G
iature of Property Owner-Y 1 '1 ►rsniP