General Permits (4501)

Applicant N
Address
CERTIFICATION OF EXEMPTION
FROM REQUIRING A CAMA PERMITS
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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Phone Number r//( 3d � — P '17
City State 4, C Zip L c
Project Location (County, State Road, Water Body, etc.) C of -i t _o C-; v M 4 11 L
Type and Dimensions of Project , .�i� Ir %y.1 , H 1S 'r 4 ' n- / 4 L. -A !(, " `L.
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The proposed project o be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit re- valid for 90 days from the date of issuance. Following expiration,
quirement pursuant to 15 NCAC 7K .0203. This exemption to a re-examination of the project and project site may be necessary
CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining any other State, Federal, or Local authorization.
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Any person who proceeds with a development without the con-
sent of a CAMA official under the 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 (1) the ap-
plicant has read and will abide by the conditions of this exemp-
tion, and (2) a written statement has been obtained from adjacent
landowners certifying that they have no objections to the
proposed work.
Applirrant's signature
CAMA Official's signature
-7 - /i y 7
Issuing date
?-�-7
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203
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-g� ��� DOCKS BY CARLTON
1697 FREEDOM WAY
fIUBERT NC 28539
910-353-4772
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No V410 66 r-0 eoN rf 564-y441-
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We hereby propose to furnish labor and materials — complete in accordance with the above specifications for the sum of,
-rd C 41tt:i) 'WC ikfi- b NiAIffif dollars—($ q, -�%-o. ) with payment to be made as
follows: 114fF& 4
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All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.
Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become
an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. In the event
of a termination of this contract, the owner agrees to pay as liquidated damages frften percent (15%) of the contract sum. In the further event
that the owner fails to pay any sum due under this contract, and the contractor employs attorneys, the owner agrees to pay all costs of
collection, including attorney's fees of twenty percent (20%).
NOTE: This proposal will be wtihdrawn by us if not accepted within 30 days.
6
Authorized Signature
A EPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.
Payment will be made as outlined above. / Z
ACCEPTED: Date Signature
(customer signs here)