Stuart Barley

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Applicant Name
Address �
City UU 1 w
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.
Type and Dimensions of Project
Phone Number 11 1 h(0B -nq D
The proposed project to 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.
s signature
Issuing date T
co /; // .
Expiration date
Attachment: 15 North Carolina Administrative Code 7K .0203

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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 q
suant to 15 NCAC Subchapter 7K .0203.
Applicant Na e QSQ Phone Nu mt"f "yY i.P
Address I
City State zip-
Pr 'ect Loc n unt , St a Road Water Body, et .) C
` Type apd Pimensions of Project
The proposed project to be located and constructed as described
above is hereby certified as exempt from the CAMA permit re-
quirement pursuant to 15 NCAC 7K .0203. 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 90 days from the date of issuance. Following expiration,
a re-examination of the project and project she may be necessary
to continue this certification.
I SKETCH (SCALE: ) I
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 f rom adjacent
landowners certifying that they have no objections to the
proposed work.
Issuing
�d& -- ( IQ-
Exoiratiorf t31date
Attachment: 15 North Carolina A tr�P�9
APR 0 3 2017

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as 1' 41 1 t .1Y ''��� 17fl "1 accordance drawings 1 sI' . 1 submittedforabove1 1
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11 payments to 1'madefollows.
Respectfully?tions involving ema costs 1 1
onungent upon qtokes, Per
acceptedmil becorn an extra charge
NotF - ThiR proposal may be withdrawn by us if not within days
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QSAL The above prices, specifications, and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. Payments will be made as outlined above.
Signature
Signature

FD � _ESS_ ADDRESS
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HONE NO- TDA�TEOF PLASTAN'
fie hereby propose to furnish Lhe matelia16 itrld IjOfforfll [he labor ll()r;ljssjjry for the completion of
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below r addttlonal descriptiiori af
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aranteed to be as specified, and the above %\,V4 tia4*eo�red in accordance with the drawings and specifications subtLd'ited for above work and
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enlphzk� in Dstantial workmanlike manner for the SUM Of
($ with payments to be Made as follows. EZ M
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Any aftefation or deviation trorn above specifications involving extra costs Respectfully submitted .
willibe executed only upon written order, and will become an extra chafge
ova( and above the estimate. All agreements contingent upon strikes, Per
accidents, of delays beyond our control.
Note- This piopu5al may pe withdrawn byTitr K @accepted wflttiR_,,-- _ ..days.
ACCEPTANCE OF PROPOSAL The above prices, specifications, and conditions are satisfactoryand are hereby accepted. You are authorized to do the work as
specified. Payments will be made as outlined above.
Signature
,Pate Signature----
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