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UDO Administrative Manual - Currituck County Government

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Date ________________________N.C. DIVISION OF COASTAL MANAGEMENTAGENT AUTHORIZATION FORMName of Property Owner Applying for Permit:__________________________________________________Mailing Address:____________________________________________________________________________________________________I certify that I have authorized (agent) _________________________________ to act on mybehalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install orconstruct (activity) ____________________________________________________, at (my propertylocated at) _____________________________________________________.This certification is valid thru (date) ___________________________.______________________________________________________________________________Property Owner SignatureDate<strong>Administrative</strong> <strong>Manual</strong>Page 2.54CAMA Minor ApplicationPage 10 of 10

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