Knedlik

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.
cant Name l�' 0,J,4Ld 11 Ned L, k %G A!>Qx P&/n P n Phone Number 2 r - f
ess l z s o VJ SY . 0. /V w 7
�? " State
ict Location ( ounty, State Road, Water Body, etc.) 19,o7
J
V
Zip
and Dimensions of Project , e c �� /n P� t 5��� r3,
roposed project to be located and constructed as described
is hereby certified as exempt from the CAMA permit re-
nent pursuant to 15 NCAC 7K .0203. This exemption to
% permit requirements does not alleviate the necessity of
)btaining any other State, Federal, or Local authorization.
This certification of exemption from requiring a CAMA pert
valid for 90 days from the date of issuance. Following expir<
a re-examination of the project and project site may be nece:
to continue this certification.
:TCH (SCALE:

HCDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal ManaWn-ent
Beverly Eaves Perdue James H. Grewn Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date:
Name of Property Owner Applying for Permit, Name of Authorized Agent for this project
Owner's MaNng Address.-
"
yr
Phone Number 6"
Agent's Uaffing Address:
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
lstn kt C cn(�C,T--
(my property located) at lLAO-7 Ccm kn'�& -` ?.)C*nr -4
This certification is valid thru (date)
V Property Owner Signature Date

Town of Sunset Beach
Permit Application
Trades
Permit Number
700 Sunset Blvd. North
Sunset Beach, NC 28468
Phone: [phone]
Fax: [phone]
Tax Parcel Number:
Project Address:
,ILA L, 32-
Property Owner:
Property Owner Mailing Address:
30KLLI
Property Owner Telephone Numbers (s):
Home: 5 i LS-AL-C, Cell: tz'
Project Information
Structure Use: (1) Residential O Conunercial O Governmental
Project Type: (v4 Building ( ) Electrical ( ) Mechanical ( ) Plumbing
Description of Project: � I Vr- r,!A
Applicant/Contactor: -ADE-k t'-ICMC . kt-nrxc-�'i&rmen�
Address:
citr. ( cA1ay-)cksn State: Zip:
Phone: "" Cell: Fax:
NC License#: Class: Expiration:
Email Address: Kra J� r� I -Iy�.
Additional Contractor:
Address:
City: --
Phone:
NC Licenseg:
Email Address:
Cell:
Class:
State:
M
Fax:
Expiration:
Total Project Cost: S ( nc)
Signature of Applicant/Agent g
X
N'
Printed Name of Applicant/Agent: C \C G C3 Date: —

TnWhom itMay Concern:
iRnnald Knedlik, give permission to Apex Home improvements to do work on my bulkhead on 1407
Thank you,
AL
Ronald Knedlik

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EFS Consultants
Edward F. Schaack, P.E.
80 Calabash 6n7e
Calabash, North Carolina 28457
January 21,2011
Mr. Nick Gavrilis
Apex Home Improvements
Re: Invoice #012111
910-579-4639
Fax: [phone]
Project: Residence at 1407 Canal Drive - Sunset Beadh,NC
Service: Design and peparation of construction drawings for
the replacement of two tie back rods.
My fee for the above service is $500.00
0
Invoice is payable upon receipt.
Very truly,
Idward F. Schaack P.E.