Thomas (4)

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.
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giant Name B,i S) 7 f1Gm"1 ' `f0 /fie .,q,i I?I Aa t 3 Phone Number
'ss 15 G,'r,UdL/9—d 2cd
S State N C Zip _ 7i.
ct Location (County,State Road, Water Body, etc.) / 7 e, y,,r� �j , - r- /1 rJ',9 c e'- "7 E
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and Dimensions of Project v`cer.7,• /o< .e(01Ace Ex • i7'•7.5 I( 'x /2 ' 1:14,B71.. )cc
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
nent 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.
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03-2007 10:08 From:THB RDMIN 9108429315 To:3953964 P.3/3
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-23-2007 10:08 From:THB ADMIN 9108429315 To:3953964 P.2'3
A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F Easley, Governor Charles S.Jones, Director William G.Ross Jr.. Sec
Authorized Agent Consent Agreement
n74-)ll.R.,J is hereby authorized to act on my beha
(P:in;ed,Name ofPger,t)
in order to obtain any LAMA permit(s) required for the property listed below. The authorization is limited to I
specific activities described in the attached sketch.
LOCATION OF PROJECT:
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PROPERTY OWNER MAILING ADDRESS:
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A‘rtrcig feSa j 2 PHONE NO.Z.5-2 4Sti 5- 63
AUTHORIZED AGENT MAILING ADDRESS:
>75- C4,4-7
PHONE NO. /fir SS44Z- 44_
Signature of Property Owner 'J
Signature of Authorized Agent. ��a,,„t74.7r -