EX - Dwyer, Patrice

CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMIT
as authorized by the State of North Carolina,
Department of Environmental Quality and the Coastal Resource$ Commission in an area of
environmental concern pursuant to 15 NCAC Subchapter 7K Lor NCGS 113A-103 (5) (b) (5).
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Type and Dimensions of Project
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The proposed projectto be located and constructed as
described above is hereby certified as exempt from the
CAMA permit requirements. This exemption to CAMA
permit requirements does not alleviate the necessity of
your obtaining any other State, Federal, or Local
authorization.
This certification of exemption from requiring a CAMA permit
is valid for 120 days from the date of issuance. Following
expiration, a re-examination of the project and project site may
be necessary to continue this certification.
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Any person who proceeds with a development without the con-
sent of a LAMA official under mistaken assumption that the
development is exempted, will be in violation of the CAMA if there
is a subsequent determination that a permit was required for the
development.
The applicant certifies by signing this exemption that the
applicant will abide by the conditions of this exemption.
k A nn A/ 6Y
Applicant's signature
CAMA Official's signature
I1 P
Issuing dateyv v Expirat' ion Date

Docusign Envelope ID: 5CAO8E79-EA25-41 DO-AC94-1 BF53EODD184
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Patrice and Daniel Dwyer
Mailing Address:
Phone Number:
Email Address:
327 N Dogwood Trail
Southern Shores, NC 27949
252-207-3392
[e-mail]
I certify that I have authorized Emanuelson and Dad
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
I
necessary for the following proposed development: replace ?O tieback rods
at my property located at 327 N Dogwood Trail
in Dare
County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
V ev:
`--+�e�nenree iem.
Signature
Dan Dwyer
Print or Type Name
Title
eta/2o2f 1
Date
This certification is valid through /

V, 17
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