WI0500414_Application_20210823

North Carolina Department of Environmental Quality — Division of Water Resources
APPLICATION FOR A PERMIT TO CONSTRUCT OR OPERATE INJECTION WELL(S)
In Accordance With the Provisions of 15A NCAC 02C .0224
GEOTHERMAL HEATING/COOLING WATER RETURN WELL(S)
These well(s) inject groundwater directly into the subsurface as part of a geothermal heating and cooling system
CHECK ONE OF THE FOLLOWING:
New Application _X_Renewal* Modification Permit Rescission Request*
*For Permit Renewals or Rescission Request, complete Sections A thru E, and M (signature page) only
Print or Type Information and Mail to the Address on the Last Page. Illegible Applications Will Be Returned As Incomplete.
DATE: August 9, 2021
PERMIT NO. WI0500414 (leave blank if New Application)
A. CURRENT WELL USE & OWNERSHIP STATUS (Leave Blank if New Well/Permit Application)
1. Current Use of Well
a. I wish to continue to use the well as XI —I Geothermal Well n Drinking Water Supply Well
n Other Water Supply Use- Indicate use (i.e., irrigation, etc.)
b. Terminate Use: If the well is no longer being used as a geothermal injection well and you wish to
rescind the permit, check the box below. If abandoned, attach a copy of the Well Abandonment
Record (GW-30).
n Yes, I wish to rescind the permit
2. Current Ownership Status
Has there been a change of ownership since permit last issued? xfl YES ❑ NO
If yes, indicate New Owner's contact information:
Name(s) Sarah Cohen and Graham Diering
Mailing Address: 410 Whitehead Circle
City: Chapel Hill State: NC Zip Code: 27514 County: Orange
Day Tele No.: [phone] Email Address.: [e-mail]
B. STATUS OF APPLICANT (choose one)
Non -Government: Individual Residence X Business/Organization
Government: State Municipal County
Federal
C. WELL OWNER(S)/PERMIT APPLICANT — For single family residences, list all persons listed on the
property deed. For all others, list name of business/agency and name of person and title with delegated authority
to sign: Sarah Cohen and Graham Diering
Mailing Address: 410 Whitehead Circle
City: Chapel Hill, State: NC Zip Code: 27514 County: Orange
Day Tele No.:.J919)962-9871 Ce11 No.: [phone]
EMAIL Address: [e-mail] Fax No.:
Geothermal Water Return Well Permit Application Rev. 4-15-2016 Page 1

D. WELL OPERATOR (if different from well owner) — For single family residences, list all persons listed on
the property deed. For all others, list name business/agency and name of person and title with delegated authority
to sign: Same as above
Mailing Address:
City: State: Zip Code: County:
Day Tele No.: Email Address.:
E. PHYSICAL LOCATION OF WELL(S) SITE
(1) Parcel Identification Number (PIN) of well site: County:
(2) Physical Address (if different than mailing address): Same as above
City: County Zip Code:
F WELL DRILLER INFORMATION
Well Drilling Contractor's Name:
NC Well Drilling Contractor Certification No.:
Company Name:
Contact Person: EMAIL Address:
Address:
City: Zip Code:
Office Tele No.: Cell No.:
State:
County:
Fax No.:
G. HVAC CONTRACTOR INFORMATION (if different than driller)
HVAC Contractor's Name:
NC HVAC Contractor License No.:
Company Name:
Contact Person: EMAIL Address:
Address:
City: Zip Code: State: County:
Office Tele No.: Cell No.: Fax No.:
H. WELL USE Will the injection well(s) also be used as the supply well(s) for the following?
(1)
(2)
The injection operation?
Personal consumption?
YES
YES
NO
NO
I. WELL CONSTRUCTION REQUIREMENTS — As specified in 15A NCAC 02C .0224(d):
(1)
(2)
The water supply well shall be constructed in accordance with
15A NCAC 02C .0107.
If a separate well is used to inject the heat pump effluent, then
in accordance with the water supply well requirements of
the water supply well requirements of
the injection well shall be constructed
15A NCAC 02C .0107, except that:
Geothermal Water Return Well Permit Application Rev. 4-15-2016
Page 2

(3)
(a) For screen and gravel -packed wells, the entire length of casing shall be grouted from the top
of the gravel pack to land surface;
(b) For open-end wells without screen, the casing shall be grouted from the bottom of the casing
to land surface.
A sampling tap or other approved collection equipment shall provide a functional source of water
during system operation for the collection of water samples immediately after water emerges from the
supply well and immediately prior to injection.
J. WELL CONSTRUCTION SPECIFICATIONS
(1) Specify the number and type of wells to be used for the geothermal heating/cooling system:
*EXISTING WELLS PROPOSED WELLS
*For existing wells, please attach a copy of the Well Construction Record (Form GW-1) if available.
(2) Attach a schematic diagram of each water supply and injection well serving the geothermal
heating/cooling system. A single diagram can be used for wells having the same construction
specifications as long as the diagram clearly identifies or distinguishes each well from one another.
Each diagram shall demonstrate compliance with the well construction requirements specified in Part
H above and shall include, at a minimum, the following well construction specifications:
(a) Depth of each boring below land surface
(b) Well casing and screen type, thickness, and diameter
(c) Casing depth below land surface
(d) Casing height "stickup" above land surface
(e) Grout material(s) surrounding casing and depth below land surface
Note: bentonite grouts are prohibited for sealing water -bearing zones with 1500
mg/L chloride or greater per 15A NCAC 02C .01070(8)
(f) Length of well screen or open borehole and depth below land surface
(g)
Length of sand or gravel packing around well screen and depth below land surface
K. OPERATING DATA
(1) Injection Rate: Average (daily) gallons per minute (gpm).
(2) Injection Volume: Average (daily) gallons per day (gpd).
(3) Injection Pressure: Average (daily) pounds/square inch (psi).
(4) Injection Temperature: Average (January) ° F, Average (July) ° F.
L. SITE MAP — As specified in 15A NCAC 02C .0224(b)(4), attach a site -specific map that is scaled or otherwise
accurately indicates distances and orientations of the specified features from the injection well(s). The site map shall
include the following:
(1) All water supply wells, surface water bodies, and septic systems including drainfield, waste
application area, and repair area located within 250 feet of the injection well(s).
(2) Any other potential sources of contamination listed in 15A NCAC 02C .0107(a)(2) located within 250
feet of the proposed injection well(s).
(3) Property boundaries located within 250 feet of the parcel on which the proposed injection well(s) are
to be located.
(4) An arrow orienting the site to one of the cardinal directions (north, south, west, or east)
Geothermal Water Return Well Permit Application Rev. 4-15-2016 Page 3

NOTE: In most cases an aerial photograph of the property parcel showing property lines and structures can be
obtained and downloaded from the applicable county GIS website. Typically, the property can be searched by
owner name or address. The location of the wells in relation to property boundaries, houses, septic tanks, other
wells, etc. can then be drawn in by hand. Also, a `layer' can be selected showing topographic contours or elevation
data
M. CERTIFICATION (to be signed as required below or by that person's authorized agent)
15A NCAC 02C .0211(e) requires that all permit applications shall be signed as follows:
1. for a corporation: by a responsible corporate officer;
2. for a partnership or sole proprietorship: by a general partner or the proprietor, respectively;
3. for a municipality or a state, federal, or other public agency: by either a principal executive officer
or ranking publicly elected official;
4. for all others: by all the person(s) listed on the property deed.
If an authorized agent is signing on behalf of the applicant, then supply a letter signed by the
applicant that names and authorizes their agent to sign this application on their behalf.
"I hereby certify, under penalty of law, that I have personally examined and am familiar with the information
submitted in this document and all attachments thereto and that, based on my inquiry of those individuals
immediately responsible for obtaining said information, I believe that the information is true, accurate and
complete. I am aware that there are significant penalties, including the possibility of fines and imprisonment,
for submitting false information. I agree to construct, operate, maintain, repair, and if applicable, abandon the
injection well and all related appurtenances in accordance with the approved specifications and conditions of the
Permit."
Signature of Property Owner/Applicant
Sarah Cohen
Print or Type Full Name and Title
PiQi�Owner/ApplicantSignature of Property Owner/Applicant
Graham Hugh Diering
Print or Type Full Name and Title
Signature of Authorized Agent, if any
Print or Type Full Name and Title
Submit two copies of the completed application package to:
Division of Water Resources - UIC
Water Quality Regional Operations Section (WQROS)
1636 Mail Service Center
Raleigh, NC 27699-1636
Telephone [phone]
Geothermal Water Return Well Permit Application Rev. 4-15-2016 Page 4

OFFER TO PURCHASE AND CONTRACT
[Consult "Guidelines" (Form 2G) for guidance in completing this form]
For valuable consideration, the receipt and legal sufficiency of which are hereby acknowledged, Buyer offers to purchase and Seller upon
acceptance agrees to sell and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any addendum
or modification made in accordance with its terms (together the "Contract").
1. TERMS AND DEFINITIONS: The terms listed below shall have the respective meaning given them as set forth adjacent to each
term.
(a) "Seller":
(b) "Buyer":
James Bartram and Jane Bailey
Graham Hugh Diering and Sarah Cohen
(c) "Property": The Property shall include all that real estate described below together with all appurtenances thereto including the
improvements located thereon and the fixtures and personal property listed in Paragraphs 2 and 3 below.
NOTE: If the Property will include a manufactured (mobile) home(s), Buyer and Seller should consider including the Manufactured
(Mobile) Home provision in the Additional Provisions Addendum (Standard Form 2A11-T) with this offer.
Street Address:
City:
County:
410 Whitehead Cir
Orange
Chapel Hill
, North Carolina
Zip:
27514-4833
NOTE: Governmental authority over taxes, zoning, school
districts, utilities and mail delivery may differ from address shown.
1
Legal Description: (Complete ALL applicable)
Plat Reference: Lot/Unit 5 & 7 , Block/Section
, Subdivision/Condominium Whitehead Circle Dev
, as shown on Plat Book/Slide
The PIN/PID or other identification number of the Property is: 9788418347
Other description:
Some or all of the Property may be described in Deed Book 4855 at Page 213
4
(d)
"Purchase Price":
$ 712,500.00 paid in U.S. Dollars upon the following terms:
$ 10,000 00 BY DUE DILIGENCE FEE made payable and delivered to Seller by the Effective Date.
$ 15,000 00 BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Escrow
Agent named in Paragraph 1(f) by ❑ cash © personal check ❑ official bank check
❑ wire transfer, ❑ electronic transfer, EITHER ❑ with this offer OR X❑within
five (5) days of the Effective Date of this Contract.
$ BY (ADDITIONAL) EARNEST MONEY DEPOSIT made payable and delivered to
Escrow Agent named in Paragraph 1(f) by cash, official bank check, wire transfer or
electronic transfer no later than , TIME
BEING OF THE ESSENCE with regard to said date.
$ BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the
existing loan(s) secured by a deed of trust on the Property in accordance with the attached
Loan Assumption Addendum (Standard Form 2A6-T).
$ BY SELLER FINANCING in accordance with the attached Seller Financing Addendum
(Standard Form 2A5-T).
$ BY BUILDING DEPOSIT in accordance with the attached New Construction Addendum
(Standard Form 2A3-T).
$ 687,500.00 BALANCE of the Purchase Price in cash at Settlement (some or all of which may be paid
with the proceeds of a new loan).
Should Buyer fail to deliver either the Due Diligence Fee or any Initial Earnest Money Deposit by their due dates, or should any
check or other funds paid by Buyer be dishonored, for any reason, by the institution upon which the payment is drawn, Buyer shall
I '
This form jointly approved by:
North Carolina Bar Association
North Carolina Association of REALTORS®, Inc.
REALTOR°
Buyer initials
Bagwell Holt Smith P.A., 400 Market Street Chapel Hill NC 27516 Phone: [phone] - Fax: Cohen-Diering
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Page 1 of 13
SUPINOUSING
OPPORTUNITY
at Page(s) 77
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have one (1) banking day after written notice to deliver cash, official bank check, wire transfer or electronic transfer to the payee. In
the event Buyer does not timely deliver the required funds, Seller shall have the right to terminate this Contract upon written notice
to Buyer.
(e) "Earnest Money Deposit": The Initial Earnest Money Deposit, the Additional Earnest Money Deposit and any other earnest
monies paid or required to be paid in connection with this transaction, collectively the"Earnest Money Deposit", shall be deposited
and held in escrow by Escrow Agent until Closing, at which time it will be credited to Buyer, or until this Contract is otherwise
terminated. In the event: (1) this offer is not accepted; or (2) a condition of any resulting contract is not satisfied, then the Earnest
Money Deposit shall be refunded to Buyer. In the event of breach of this Contract by Seller, the Earnest Money Deposit shall be
refunded to Buyer upon Buyer's request, but such return shall not affect any other remedies available to Buyer for such breach. In
the event of breach of this Contract by Buyer, the Earnest Money Deposit shall be paid to Seller as liquidated damages and as
Seller's sole and exclusive remedy for such breach, but without limiting Seller's rights under Paragraphs 4(d) and 4(e) for damage to
the Property or Seller's right to retain the Due Diligence Fee. It is acknowledged by the parties that payment of the Earnest Money
Deposit to Seller in the event of a breach of this Contract by Buyer is compensatory and not punitive, such amount being a
reasonable estimation of the actual loss that Seller would incur as a result of such breach. The payment of the Earnest Money
Deposit to Seller shall not constitute a penalty or forfeiture but actual compensation for Seller's anticipated loss, both parties
acknowledging the difficulty determining Seller's actual damages for such breach. If legal proceedings are brought by Buyer or
Seller against the other to recover the Earnest Money Deposit, the prevailing party in the proceeding shall be entitled to recover from
the non -prevailing party reasonable attorney fees and court costs incurred in connection with the proceeding.
(f) "Escrow Agent" (insert name): Bagwell Holt Smith P.A.
NOTE: In the event of a dispute between Seller and Buyer over the disposition of the Earnest Money Deposit held in escrow, a
licensed real estate broker ("Broker") is required by state law (and Escrow Agent, if not a Broker, hereby agrees) to retain the
Earnest Money Deposit in the Escrow Agent's trust or escrow account until Escrow Agent has obtained a written release from the
parties consenting to its disposition or until disbursement is ordered by a court of competent jurisdiction. Alternatively, if a Broker or
an attorney licensed to practice law in North Carolina ("Attorney") is holding the Earnest Money Deposit, the Broker or Attorney
may deposit the disputed monies with the appropriate clerk of court in accordance with the provisions of N.C.G.S. §93A-1 2.
THE PARTIES AGREE THAT A REAL ESTATE BROKERAGE FIRM ACTING AS ESCROW AGENT MAY PLACE THE
EARNEST MONEY DEPOSIT IN AN INTEREST BEARING TRUST ACCOUNT AND THAT ANY INTEREST EARNED
THEREON SHALL BE DISBURSED TO THE ESCROW AGENT MONTHLY IN CONSIDERATION OF THE EXPENSES
INCURRED BY MAINTAINING SUCH ACCOUNT AND RECORDS ASSOCIATED THEREWITH.
(g) "Effective Date": The date that: (1) the last one of Buyer and Seller has signed or initialed this offer or the final counteroffer, if
any, and (2) such signing or initialing is communicated to the party making the offer or counteroffer, as the case may be. The parties
acknowledge and agree that the initials lines at the bottom of each page of this Contract are merely evidence of their having
reviewed the terms of each page, and that the complete execution of such initials lines shall not be a condition of the effectiveness of
this Agreement.
(h) "Due Diligence": Buyer's opportunity to investigate the Property and the transaction contemplated by this Contract, including
but not necessarily limited to the matters described in Paragraph 4 below, to decide whether Buyer, in Buyer's sole discretion, will
proceed with or terminate the transaction.
(i) "Due Diligence Fee": A negotiated amount, if any, paid by Buyer to Seller with this Contract for Buyer's right to terminate the
Contract for any reason or no reason during the Due Diligence Period. It shall be the property of Seller upon the Effective Date and
shall be a credit to Buyer at Closing. The Due Diligence Fee shall be non-refundable except in the event of a material breach of this
Contract by Seller, or if this Contract is terminated under Paragraph 8(n) or Paragraph 12, or as otherwise provided in any addendum
hereto. Buyer and Seller each expressly waive any right that they may have to deny the right to conduct Due Diligence or to assert
any defense as to the enforceability of this Contract based on the absence or alleged insufficiency of any Due Diligence Fee, it being
the intent of the parties to create a legally binding contract for the purchase and sale of the Property without regard to the existence
or amount of any Due Diligence Fee.
(j) "Due Diligence Period": The period beginning on the Effective Date and extending through 5:00 p.m. on
June 29, 2018 TIME BEING OF THE ESSENCE
with regard to said date.
(k) "Settlement": The proper execution and delivery to the closing attorney of all documents necessary to complete the transaction
contemplated by this Contract, including the deed, settlement statement, deed of trust and other loan or conveyance documents, and
the closing attorney's receipt of all funds necessary to complete such transaction.
(1) "Settlement Date": The parties agree that Settlement will take place on September 28 , 2018
(the "Settlement Date"), unless otherwise agreed in writing, at a time and place designated by Buyer.
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Buyer initials li?Seller initials
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Cohen-Diering

(m) "Closing": The completion of the legal process which results in the transfer of title to the Property from Seller to Buyer, which
includes the following steps: (1) the Settlement (defined above); (2) the completion of a satisfactory title update to the Property
following the Settlement; (3) the closing attorney's receipt of authorization to disburse all necessary funds; and (4) recordation in the
appropriate county registry of the deed(s) and deed(s) of trust, if any, which shall take place as soon as reasonably possible for the
closing attorney after Settlement. Upon Closing, the proceeds of sale shall be disbursed by the closing attorney in accordance with
the settlement statement and the provisions of Chapter 45A of the North Carolina General Statutes. If the title update should reveal
unexpected liens, encumbrances or other title defects, or if the closing attorney is not authorized to disburse all necessary funds, then
the Closing shall be suspended and the Settlement deemed delayed under Paragraph 13 (Delay in Settlement/Closing).
WARNING: The North Carolina State Bar has determined that the performance of most acts and services required for a closing
constitutes the practice of law and must be performed only by an attorney licensed to practice law in North Carolina. State law
prohibits unlicensed individuals or firms from rendering legal services or advice. Although non -attorney settlement agents may
perform limited services in connection with a closing, they may not perform all the acts and services required to complete a closing.
A closing involves significant legal issues that should be handled by an attorney. Accordingly it is the position of the North Carolina
Bar Association and the North Carolina Association of REALTORS® that all buyers should hire an attorney licensed in North
Carolina to perform a closing.
(n) "Special Assessments": A charge against the Property by a governmental authority in addition to ad valorem taxes and
recurring governmental service fees levied with such taxes, or by an owners' association in addition to any regular assessment (dues),
either of which may be a lien against the Property. A Special Assessment may be either proposed or confirmed.
"Proposed Special Assessment": A Special Assessment that is under formal consideration but which has not been approved prior
to Settlement.
"Confirmed Special Assessment": A Special Assessment that has been approved prior to Settlement whether or not it is fully
payable at time of Settlement.
2. FIXTURES AND EXCLUSIONS.
(a) Specified Items: Unless identified in subparagraph (d) below, the following items, including all related equipment and remote
control devices, if any, are deemed fixtures and shall convey, included in the Purchase Price free of liens:
• Alarm and security systems (attached) for security, fire,
smoke, carbon monoxide or other toxins with all related
access codes, sensors, cameras, dedicated monitors, hard
drives, video recorders, power supplies and cables;
doorbells/chimes
• All stoves/ranges/ovens; built-in appliances; attached
microwave oven; vent hood
• Antennas; satellite dishes and receivers
• Basketball goals and play equipment (permanently attached
or in -ground)
• Ceiling and wall -attached fans; light fixtures (including
existing bulbs)
• Fireplace insert; gas logs or starters; attached fireplace
screens; wood or coal stoves
• Floor coverings (attached)
• Fuel tank(s) whether attached or buried and including any
contents that have not been used, removed or resold to the
fuel provider as of Settlement. NOTE: Seller's use, removal
or resale of fuel in any fuel tank is subject to Seller's
obligation under Paragraph 8(c) to provide working, existing
utilities through the earlier of Closing or possession by
Buyer.
• Garage door openers with all controls
Buyer initials
• Generators that are permanently wired
• Invisible fencing with power supply, controls and receivers
• Landscape and outdoor trees and plants (except in moveable
containers); raised garden; landscape and foundation
lighting; outdoor sound systems; permanent irrigation
systems and controls; rain barrels; landscape water features;
address markers
• Mailboxes; mounted package and newspaper receptacles
• Mirrors attached to walls, ceilings, cabinets or doors; all
bathroom wall mirrors
• Storage shed; utility building
• Swimming pool (excluding inflatable); spa; hot tub
• Solar electric and solar water heating systems
• Sump -pumps, radon fans and crawlspace ventilators;
de -humidifiers that are permanently wired
• Surface -mounting brackets for television and speakers;
recess -mounted speakers; mounted intercom system
• Water supply equipment, including filters, conditioning and
softener systems; re -circulating pumps; well pumps and
tanks
• Window/Door blinds and shades, curtain and drapery rods
and brackets, door and window screens and combination
doors, awnings and storm windows
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Seller initials
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(b) Items Leased or Not Owned: Any item which is leased or not owned by Seller, such as fuel tanks, antennas, satellite dishes and
receivers, appliances, and alarm and security systems must be identified here and shall not convey:
None.
(c) Other Fixtures/Unspecified items: Unless identified in subparagraph (d) below, any other item legally considered a fixture is
included in the Purchase Price free of liens.
(d) Other Items That Do Not Convey: The following items shall not convey (ident5 those items to be excluded under
subparagraphs (a) and (c)): Red Light in Dining Room
Seller shall repair any damage caused by removal of any items excepted above.
3. PERSONAL PROPERTY: The following personal property shall be transferred to Buyer at no value at Closing: Washer ,
Dryer, Refrigerator, Stove, Dishwasher, Wine Cooler
NOTE: Buyer is advised to consult with Buyer's lender to assure that the Personal Property items listed above can be included in this
Contract.
4. BUYER'S DUE DILIGENCE PROCESS:
WARNING: BUYER IS STRONGLY ENCOURAGED TO CONDUCT DUE DILIGENCE DURING THE DUE
DILIGENCE PERIOD. If Buyer is not satisfied with the results or progress of Buyer's Due Diligence, Buyer should terminate this
Contract, PRIOR TO THE EXPIRATION OF THE DUE DILIGENCE PERIOD, unless Buyer can obtain a written extension from
Seller. SELLER IS NOT OBLIGATED TO GRANT AN EXTENSION. Although Buyer may continue to investigate the Property
following the expiration of the Due Diligence Period, Buyer's failure to deliver a Termination Notice to Seller prior to the expiration
of the Due Diligence Period will constitute a waiver by Buyer of any right to terminate this Contract based on any matter relating to
Buyer's Due Diligence. Provided however, following the Due Diligence Period, Buyer may still exercise a right to terminate if Seller
fails to materially comply with any of Seller's obligations under Paragraph 8 of this Contract or for any other reason permitted under
the terms of this Contract or North Carolina law.
(a) Loan: Buyer, at Buyer's expense, shall be entitled to pursue qualification for and approval of the Loan if any.
NOTE: Buyer's obligation to purchase the Property is not contingent on obtaining a Loan. Therefore, Buyer is advised to consult
with Buyer's lender prior to signing this offer to assure that the Due Diligence Period allows sufficient time for the appraisal to be
completed and for Buyer's lender to provide Buyer sufficient information to decide whether to proceed with or terminate the
transaction.
(b) Property Investigation: Buyer or Buyer's agents or representatives, at Buyer's expense, shall be entitled to conduct all desired
tests, surveys, appraisals, investigations, examinations and inspections of the Property as Buyer deems appropriate, including but
NOT limited to the following:
(i) Inspections: Inspections to determine the condition of any improvements on the Property, the presence of unusual
drainage conditions or evidence of excessive moisture adversely affecting any improvements on the Property, the presence of
asbestos or existing environmental contamination, evidence of wood -destroying insects or damage therefrom, and the presence
and level of radon gas on the Property.
(ii) Review of Documents: Review of the Declaration of Restrictive Covenants, Bylaws, Articles of Incorporation, Rules and
Regulations, and other governing documents of any applicable owners' association and/or subdivision. If the Property is subject
to regulation by an owners' association, it is recommended that Buyer review the completed Residential Property and Owners'
Association Disclosure Statement provided by Seller prior to signing this offer. It is also recommended that the Buyer determine
if the owners' association or its management company charges fees for providing information required by Buyer's lender or
confirming restrictive covenant compliance.
(iii) Insurance: Investigation of the availability and cost of insurance for the Property.
(iv) Appraisals: An appraisal of the Property.
(v) Survey: A survey to determine whether the property is suitable for Buyer's intended use and the location of easements,
setbacks, property boundaries and other issues which may or may not constitute title defects.
(vi) Zoning and Governmental Regulation: Investigation of current or proposed zoning or other governmental regulation
that may affect Buyer's intended use of the Property, adjacent land uses, planned or proposed road construction, and school
attendance zones.
Buyer initials
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Seller initials
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Cohen-Diering

(vii) Flood Hazard: Investigation of potential flood hazards on the Property, and/or any requirement to purchase flood
insurance in order to obtain the Loan.
(viii) Utilities and Access: Availability, quality, and obligations for maintenance of utilities including water, sewer, electric,
gas, communication services, stormwater management, and means of access to the Property and amenities.
(ix) Streets/Roads: Investigation of the status of the street/road upon which the Property fronts as well as any other street/road
used to access the Property, including: (1) whether any street(s)/road(s) are public or private, (2) whether any street(s)/road(s)
designated as public are accepted for maintenance by the State of NC or any municipality, or (3) if private or not accepted for
public maintenance, the consequences and responsibility for maintenance and the existence, terms and funding of any
maintenance agreements.
(x) Fuel Tank: Inspections to determine the existence, type and ownership of any fuel tank located on the Property.
NOTE: Buyer is advised to consult with the owner of any leased fuel tank regarding the terms under which Buyer may lease
the tank and obtain fuel.
(c) Repair/Improvement Negotiations/Agreement: Buyer acknowledges and understands that unless the parties agree
otherwise, THE PROPERTY IS BEING SOLD IN ITS CURRENT CONDITION. Buyer and Seller acknowledge and understand
that they may, but are not required to, engage in negotiations for repairs/improvements to the Property. Buyer is advised to make
any repair/improvement requests in sufficient time to allow repair/improvement negotiations to be concluded prior to the expiration
of the Due Diligence Period. Any agreement that the parties may reach with respect to repairs/improvements shall be considered an
obligation of the parties and is an addition to this Contract and as such, must be in writing and signed by the parties in accordance
with Paragraph 20.
INOTE: See Paragraph 8(c), Access to Property and Paragraph 8(m), Negotiated Repairs/Improvements.
(d) Buyer's Obligation to Repair Damage: Buyer shall, at Buyer's expense, promptly repair any damage to the Property resulting
from any activities of Buyer and Buyer's agents and contractors, but Buyer shall not be responsible for any damage caused by
accepted practices either approved by the N.C. Home Inspector Licensure Board or applicable to any other N.C. licensed
professional performing reasonable appraisals, tests, surveys, examinations and inspections of the Property. This repair obligation
shall survive any termination of this Contract.
(e) Indemnity: Buyer will indemnify and hold Seller harmless from all loss, damage, claims, suits or costs, which shall arise out of
any contract, agreement, or injury to any person or property as a result of any activities of Buyer and Buyer's agents and contractors
relating to the Property except for any loss, damage, claim, suit or cost arising out of pre-existing conditions of the Property and/or
out of Seller's negligence or willful acts or omissions. This indemnity shall survive this Contract and any termination hereof.
(f) Buyer's Right to Terminate: Buyer shall have the right to terminate this Contract for any reason or no reason, by delivering to
Seller written notice of termination (the "Termination Notice") during the Due Diligence Period (or any agreed -upon written
extension of the Due Diligence Period), TIME BEING OF THE ESSENCE. If Buyer timely delivers the Termination Notice, this
Contract shall be terminated and the Earnest Money Deposit shall be refunded to Buyer.
(g) CLOSING SHALL CONSTITUTE ACCEPTANCE OF THE PROPERTY IN ITS THEN EXISTING CONDITION
UNLESS PROVISION IS OTHERWISE MADE IN WRITING.
5. BUYER REPRESENTATIONS:
(a) Loan: Buyer X❑ does ❑ does not intend to obtain a new loan in order to purchase the Property. If Buyer is obtaining a new
loan, Buyer intends to obtain a loan as follows: ❑ FHA ❑ VA (attach FHA/VA Financing Addendum) X❑ Conventional
❑ Other: loan at a ❑ Fixed Rate ❑ Adjustable Rate in the principal amount of TBD
plus any financed VA Funding Fee or FHA MIP for a term of 15 year(s), at an initial interest rate not to exceed
3.875 % per annum (the "Loan").
NOTE: Buyer's obligations under this Contract are not conditioned upon obtaining or closing any loan.
1
NOTE: If Buyer does not intend to obtain a new loan, Seller is advised, prior to signing this offer, to obtain documentation from
Buyer which demonstrates that Buyer will be able to close on the Property without the necessity of obtaining a new loan.
(b) Other Property: Buyer ❑ does X❑ does not have to sell or lease other real property in order to qualify for a new loan or to
complete purchase.
NOTE: This Contract is not conditioned upon the sale of Buyer's property unless a contingent sale addendum such as Standard
Form 2A2-T is made a part of this Contract.
Page 5 of 13
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1

(c) Performance of Buyer's Financial Obligations: To the best of Buyer's knowledge, there are no other circumstances or
conditions existing as of the date of this offer that would prohibit Buyer from performing Buyer's financial obligations in accordance
with this Contract, except as may be specifically set forth herein.
(d) Residential Property and Owners' Association Property Disclosure Statement (check only one):
X❑ Buyer has received a signed copy of the N.C. Residential Property and Owners' Association Disclosure Statement prior to the
signing of this offer.
❑ Buyer has NOT received a signed copy of the N.C. Residential Property and Owners' Association Disclosure Statement prior to
the signing of this offer and shall have the right to terminate or withdraw this Contract without penalty (including a refund of
any Due Diligence Fee) prior to WHICHEVER OF THE FOLLOWING EVENTS OCCURS FIRST: (1) the end of the third
calendar day following receipt of the Disclosure Statement; (2) the end of the third calendar day following the Effective Date; or
(3) Settlement or occupancy by Buyer in the case of a sale or exchange.
❑ Exempt from N.C. Residential Property and Owners' Association Disclosure Statement because (SEE GUIDELINES):
(e) Mineral and Oil and Gas Rights Mandatory Disclosure Statement (check only one):
J Buyer has received a signed copy of the N.C. Mineral and Oil and Gas Rights Mandatory Disclosure Statement prior to the
signing of this offer.
❑ Buyer has NOT received a signed copy of the N.C. Mineral and Oil and Gas Rights Mandatory Disclosure Statement prior to the
signing of this offer and shall have the right to terminate or withdraw this Contract without penalty (including a refund of any
Due Diligence Fee) prior to WHICHEVER OF THE FOLLOWING EVENTS OCCURS FIRST: (1) the end of the third calendar
day following receipt of the Disclosure Statement; (2) the end of the third calendar day following the Effective Date; or (3)
Settlement or occupancy by Buyer in the case of a sale or exchange.
❑ Exempt from N.C. Mineral and Oil and Gas Rights Mandatory Disclosure Statement because (SEE GUIDELINES):
Buyer's receipt of a Mineral and Oil and Gas Rights Mandatory Disclosure Statement does not modify or limit the obligations of
Seller under Paragraph 8(g) of this Contract and shall not constitute the assumption or approval by Buyer of any severance of
mineral and/or oil and gas rights, except as may be assumed or specifically approved by Buyer in writing.
NOTE: The parties are advised to consult with a NC attorney prior to signing this Contract if severance of mineral and/or oil and
gas rights has occurred or is intended.
6. BUYER OBLIGATIONS:
(a) Responsibility for Proposed Special Assessments: Buyer shall take title subject to all Proposed Special Assessments.
(b) Responsibility for Certain Costs: Buyer shall be responsible for all costs with respect to:
(i) any loan obtained by Buyer, including charges by an owners association and/or management company as agent of an owners'
association for providing information required by Buyer's lender;
(ii) charges required by an owners' association declaration to be paid by Buyer for Buyer's future use and enjoyment of the
Property, including, without limitation, working capital contributions, membership fees, or charges for Buyer's use of the
common elements and/or services provided to Buyer, such as "move -in fees";
(iii) determining restrictive covenant compliance;
(iv) appraisal;
(v) title search;
(vi) title insurance;
(vii) any fees charged by the closing attorney for the preparation of the Closing Disclosure, Seller Disclosure and any other
settlement statement;
(viii) recording the deed; and
(ix) preparation and recording of all instruments required to secure the balance of the Purchase Price unpaid at Settlement.
(c) Authorization to Disclose Information: Buyer authorizes the Buyer's lender(s), the parties' real estate agent(s) and closing
attorney: (1) to provide this Contract to any appraiser employed by Buyer or by Buyer's lender(s); and (2) to release and disclose any
buyer's closing disclosure, settlement statement and/or disbursement summary, or any information therein, to the parties to this
transaction, their real estate agent(s) and Buyer's lender(s).
7. SELLER REPRESENTATIONS:
(a) Ownership: Seller represents that Seller:
X❑ has owned the Property for at least one year.
❑ has owned the Property for less than one year.
❑ does not yet own the Property.
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(b) Lead -Based Paint (check if applicable):
X❑ The Property is residential and was built prior to 1978 (Attach Lead -Based Paint or Lead -Based Paint Hazards Disclosure
Addendum {Standard Form 2A9-T}).
(c) Assessments: To the best of Seller's knowledge there are no Proposed Special Assessments except as follows (Insert "None" or
the identification of such assessments, if any): None .
Seller warrants that there are no Confirmed Special Assessments except as follows (Insert "None" or the identification of such
assessments, if any): None .
(d) Owners' Association(s) and Dues: Seller authorizes and directs any owners' association, any management company of the
owners' association, any insurance company and any attorney who has previously represented the Seller to release to Buyer, Buyer's
agents, representative, closing attorney or lender true and accurate copies of the following items affecting the Property, including
any amendments:
• Seller's statement of account
• master insurance policy showing the coverage provided and the deductible amount
• Declaration and Restrictive Covenants
• Rules and Regulations
• Articles of Incorporation
• Bylaws of the owners' association
• current financial statement and budget of the owners' association
• parking restrictions and information
• architectural guidelines
❑ (specify name of association): whose regular
assessments ("dues") are $ per . The name, address and telephone number of the president
of the owners' association or the association manager is:
Owners' association website address, if any:
❑ (specify name of association): whose regular
assessments ("dues") are $ per . The name, address and telephone number of the president
of the owners' association or the association manager is:
Owners' association website address, if any:
8. SELLER OBLIGATIONS:
(a) Evidence of Title, Payoff Statement(s) and Non Foreign Status:
(i) Seller agrees to use best efforts to provide to the closing attorney as soon as reasonably possible after the Effective Date,
copies of all title information in possession of or available to Seller, including but not limited to: title insurance policies,
attorney's opinions on title, surveys, covenants, deeds, notes and deeds of trust, leases, and easements relating to the Property.
(ii) Seller shall provide to the closing attorney all information needed to obtain a written payoff statement from any lender(s)
regarding any security interest in the Property as soon as reasonably possible after the Effective Date, and Seller designates
the closing attorney as Seller's agent with express authority to request and obtain on Seller's behalf payoff statements and/or
short -pay statements from any such lender(s).
(iii) If Seller is not a foreign person as defined by the Foreign Investment in Real Property Tax Act, Seller shall also provide
to the closing attorney a non -foreign status affidavit (pursuant to the Foreign Investment in Real Property Tax Act). In the
event Seller shall not provide a non -foreign status affidavit, Seller acknowledges that there may be withholding as provided
by the Internal Revenue Code.
(b) Authorization to Disclose Information: Seller authorizes: (1) any attorney presently or previously representing Seller to
release and disclose any title insurance policy in such attorney's file to Buyer and both Buyer's and Seller's agents and attorneys; (2)
the Property's title insurer or its agent to release and disclose all materials in the Property's title insurer's (or title insurer's agent's) file
to Buyer and both Buyer's and Seller's agents and attorneys and (3) the closing attorney to release and disclose any seller's closing
disclosure, settlement statement and/or disbursement summary, or any information therein, to the parties to this transaction, their real
estate agent(s) and Buyer's lender(s).
(c) Access to Property: Seller shall provide reasonable access to the Property (including working, existing utilities) through the
earlier of CIosing or possession by Buyer, including, but not limited to, allowing Buyer and/or Buyer's agents or representatives, an
opportunity to (i) conduct Due Diligence, (ii) verify the satisfactory completion of negotiated repairs/improvements, and (iii)
conduct a final walk-through inspection of the Property.
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Buyer initials
Seller initials
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NOTE: See WARNING in paragraph 4 above for limitation on Buyer's right to terminate this Contract as a result of Buyer's
continued investigation of the Property following the expiration of the Due Diligence Period.
(d) Removal of Seller's Property: Seller shall remove, by the date possession is made available to Buyer, all personal property
which is not a part of the purchase and all garbage and debris from the Property.
(e) Affidavit and Indemnification Agreement: Seller shall furnish at Settlement an affidavit(s) and indemnification agreement(s)
in form satisfactory to Buyer and Buyer's title insurer, if any, executed by Seller and any person or entity who has performed or
furnished labor, services, materials or rental equipment to the Property within 120 days prior to the date of Settlement and who may
be entitled to claim a lien against the Property as described in N.C.G.S. §44A-8 verifying that each such person or entity has been
paid in full and agreeing to indemnify Buyer, Buyer's lender(s) and Buyer's title insurer against all loss from any cause or claim
arising therefrom.
(f) Designation of Lien Agent, Payment and Satisfaction of Liens: If required by N.C.G.S. §44A-11.1, Seller shall have
designated a Lien Agent, and Seller shall deliver to Buyer as soon as reasonably possible a copy of the appointment of Lien Agent.
All deeds of trust, deferred ad valorem taxes, liens and other charges against the Property, not assumed by Buyer, must be paid and
satisfied by Seller prior to or at Settlement such that cancellation may be promptly obtained following Closing. Seller shall remain
obligated to obtain any such cancellations following Closing.
(g) Good Title, Legal Access: Seller shall execute and deliver a GENERAL WARRANTY DEED for the Property in recordable
form no later than Settlement, which shall convey fee simple marketable and insurable title, without exception for mechanics' liens,
and free of any other liens, encumbrances or defects, including those which would be revealed by a current and accurate survey of
the Property, except: ad valorem taxes for the current year (prorated through the date of Settlement); utility easements and unviolated
covenants, conditions or restrictions that do not materially affect the value of the Property; and such other liens, encumbrances or
defects as may be assumed or specifically approved by Buyer in writing. The Property must have legal access to a public right of
way.
NOTE: Buyer's failure to conduct a survey or examine title of the Property, prior to the expiration of the Due Diligence Period does
not relieve the Seller of their obligation to deliver good title under this paragraph.
NOTE: If any sale of the Property may be a "short sale," consideration should be given to attaching a Short Sale Addendum
Form 2A14-T) as an addendum to this Contract.
(h) Deed, Taxes and Fees: Seller shall pay for preparation of a deed and all other documents necessary to perform Seller's
obligations under this Contract, and for state and county excise taxes, and any deferred, discounted or rollback taxes, and local
conveyance fees required by law. The deed is to be made to: Graham Hugh Diering and Sarah Cohen, a Married
Couple
(i) Agreement to Pay Buyer Expenses: Seller shall pay at Settlement $ None . toward any of Buyer's expenses
associated with the purchase of the Property, at the discretion of Buyer and/or lender, if any, including any FHA/VA lender and
inspection costs that Buyer is not permitted to pay.
NOTE: Parties should review the FHANA Addendum prior to entering an amount in Paragraph 8(i). Certain FHANA lender and
inspection costs CANNOT be paid by Buyer at Settlement and the amount of these should be included in the blank above.
(j) Owners' Association Fees/Charges: Seller shall pay: (i) any fees required for confirming Seller's account payment information
on owners' association dues or assessments for payment or proration; (ii) any fees imposed by an owners' association and/or a
management company as agent of the owners' association in connection with the transaction contemplated by this Contract other
than those fees required to be paid by Buyer under paragraph 6(b) above; and (iii) fees incurred by Seller in completing the
Residential Property and Owners' Association Disclosure Statement, and resale or other certificates related to a proposed sale of the
Property.
(k) Payment of Confirmed Special Assessments: Seller shall pay all Confirmed Special Assessments, if any, provided that the
amount thereof can be reasonably determined or estimated. The payment of such estimated amount shall be the final payment
between the Parties.
(1) Late Listing Penalties: All property tax late listing penalties, if any, shall be paid by Seller.
(m) Negotiated Repairs/Improvements: Negotiated repairs/improvements shall be made in a good and workmanlike manner and
Buyer shall have the right to verify same prior to Settlement.
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Buyer initials
SC. Seller initials
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(n) Seller's Failure to Comply or Breach: If Seller fails to materially comply with any of Seller's obligations under this Paragraph
8 or Seller materially breaches this Contract, and Buyer elects to terminate this Contract as a result of such failure or breach, then the
Earnest Money Deposit and the Due Diligence Fee shall be refunded to Buyer and Seller shall reimburse to Buyer the reasonable
costs actually incurred by Buyer in connection with Buyer's Due Diligence without affecting any other remedies. If legal
proceedings are brought by Buyer against Seller to recover the Earnest Money Deposit, the Due Diligence Fee and/or the reasonable
costs actually incurred by Buyer in connection with Buyer's Due Diligence, the prevailing party in the proceeding shall be entitled to
recover from the non -prevailing party reasonable attorney fees and court costs incurred in connection with the proceeding.
9. PRORATIONS AND ADJUSTMENTS: Unless otherwise provided, the following items shall be prorated through the date of
Settlement and either adjusted between the parties or paid at Settlement:
(a) Taxes on Real Property: Ad valorem taxes and recurring governmental service fees levied with such taxes on real property
shall be prorated on a calendar year basis;
(b) Taxes on Personal Property: Ad valorem taxes on personal property for the entire year shall be paid by Seller unless the
personal property is conveyed to Buyer, in which case, the personal property taxes shall be prorated on a calendar year basis;
(c) Rents: Rents, if any, for the Property;
(d) Dues: Owners' association regular assessments (dues) and other like charges.
10. HOME WARRANTY: Select one of the following:
X❑ No home warranty is to be provided by Seller.
0 Buyer may obtain a one-year home warranty at a cost not to exceed $
Seller agrees to pay for it at Settlement.
❑ Seller has obtained and will provide a one-year home warranty from
at a cost of $ which includes sales tax and will pay for it at Settlement.
which includes sales tax and
NOTE: Home warranties typically have limitations on and conditions to coverage. Refer specific questions to the home warranty
company.
11. CONDITION OF PROPERTY AT CLOSING: Buyer's obligation to complete the transaction contemplated by this Contract
shall be contingent upon the Property being in substantially the same or better condition at Closing as on the date of this offer, reasonable
wear and tear excepted.
12. RISK OF LOSS: The risk of loss or damage by fire or other casualty prior to Closing shall be upon Seller. If the improvements on
the Property are destroyed or materially damaged prior to Closing, Buyer may terminate this Contract by written notice delivered to
Seller or Seller's agent and the Earnest Money Deposit and any Due Diligence Fee shall be refunded to Buyer. In the event Buyer does
NOT elect to terminate this Contract, Buyer shall be entitled to receive, in addition to the Property, any of Seller's insurance proceeds
payable on account of the damage or destruction applicable to the Property being purchased. Seller is advised not to cancel existing
insurance on the Property until after confirming recordation of the deed.
13. DELAY IN SETTLEMENT/CLOSING: Absent agreement to the contrary in this Contract or any subsequent modification
thereto, if a party is unable to complete Settlement by the Settlement Date but intends to complete the transaction and is acting in good
faith and with reasonable diligence to proceed to Settlement ("Delaying Party"), and if the other party is ready, willing and able to
complete Settlement on the Settlement Date ("Non -Delaying Party") then the Delaying Party shall give as much notice as possible to the
Non -Delaying Party and closing attorney and shall be entitled to a delay in Settlement. If the parties fail to complete Settlement and
Closing within fourteen (14) days of the Settlement Date (including any amended Settlement Date agreed to in writing by the parties) or
to otherwise extend the Settlement Date by written agreement, then the Delaying Party shall be in breach and the Non -Delaying Party
may terminate this Contract and shall be entitled to enforce any remedies available to such party under this Contract for the breach.
14. POSSESSION: Possession, including all means of access to the Property (keys, codes including security codes, garage door
openers, electronic devices, etc.), shall be delivered upon Closing as defined in Paragraph 1(m) unless otherwise provided below:
❑ A Buyer Possession Before Closing Agreement is attached (Standard Form 2A7-T)
❑ A Seller Possession After Closing Agreement is attached (Standard Form 2A8-T)
❑ Possession is subject to rights of tenant(s)
NOTE: Consider attaching Additional Provisions Addendum (Form 2A11-T) or Vacation Rental Addendum (Form 2A13-T)
Buyer initials
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SC Seller initials
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15. ADDENDA: CHECK ALL STANDARD ADDENDA THAT MAY BE A PART OF THIS CONTRACT, IF ANY, AND
ATTACH HERETO. ITEMIZE ALL OTHER ADDENDA TO THIS CONTRACT, IF ANY, AND ATTACH HERETO.
❑ Additional Provisions Addendum (Form 2A11-T)
❑ Additional Signatures Addendum (Form 3-T)
❑ Back -Up Contract Addendum (Form 2A1-T)
❑ Contingent Sale Addendum (Form 2A2-T)
❑ FHANA Financing Addendum (Form 2A4-T)
Q Lead -Based Paint Or Lead -Based Paint Hazard Addendum (Form 2A9-T)
❑ Identify other attorney or party drafted addenda: To be sold AS IS
❑ Loan Assumption Addendum (Form 2A6-T)
❑ New Construction Addendum (Form 2A3-T)
❑ Owners' Association Disclosure And Condominium
Resale Statement Addendum (Form 2Al2-T)
❑ Seller Financing Addendum (Form 2A5-T)
❑ Short Sale Addendum (Form 2A14-T)
❑ Vacation Rental Addendum (Form 2A13-T)
NOTE: UNDER NORTH CAROLINA LAW, REAL ESTATE BROKERS ARE NOT PERMI I 1 hD TO DRAFT ADDENDA TO
THIS CONTRACT.
16. ASSIGNMENTS: This Contract may not be assigned without the written consent of all parties except in connection with a tax -
deferred exchange, but if assigned by agreement, then this Contract shall be binding on the assignee and assignee's heirs and successors.
17. TAX -DEFERRED EXCHANGE: In the event Buyer or Seller desires to effect a tax -deferred exchange in connection with the
conveyance of the Property, Buyer and Seller agree to cooperate in effecting such exchange; provided, however, that the exchanging
party shall be responsible for all additional costs associated with such exchange, and provided further, that a non -exchanging party shall
not assume any additional liability with respect to such tax -deferred exchange. Buyer and Seller shall execute such additional documents,
including assignment of this Contract in connection therewith, at no cost to the non -exchanging party, as shall be required to give effect
to this provision.
18. PARTIES: This Contract shall be binding upon and shall inure to the benefit of Buyer and Seller and their respective heirs,
successors and assigns. As used herein, words in the singular include the plural and the masculine includes the feminine and neuter
genders, as appropriate.
19. SURVIVAL: If any provision herein contained which by its nature and effect is required to be observed, kept or performed after
the Closing, it shall survive the Closing and remain binding upon and for the benefit of the parties hereto until fully observed, kept or
performed.
20. ENTIRE AGREEMENT: This Contract contains the entire agreement of the parties and there are no representations,
inducements or other provisions other than those expressed herein. All changes, additions or deletions hereto must be in writing and
signed by all parties. Nothing contained herein shall alter any agreement between a REALTOR® or broker and Seller or Buyer as
contained in any listing agreement, buyer agency agreement, or any other agency agreement between them.
21. CONDUCT OF TRANSACTION: The parties agree that any action between them relating to the transaction contemplated by
this Contract may be conducted by electronic means, including the signing of this Contract by one or more of them and any notice or
communication given in connection with this Contract. Any written notice or communication may be transmitted to any mailing address,
e-mail address or fax number set forth in the "Notice Information" section below. Any notice or communication to be given to a party
herein, and any fee, deposit or other payment to be delivered to a party herein, may be given to the party or to such parry's agent. Seller
and Buyer agree that the "Notice Information" and "Acknowledgment of Receipt of Monies" sections below shall not constitute a
material part of this Contract, and that the addition or modification of any information therein shall not constitute a rejection of an offer
or the creation of a counteroffer.
22. EXECUTION: This Contract may be signed in multiple originals or counterparts, all of which together constitute one and the
same instrument.
23. COMPUTATION OF DAYS/TIME OF DAY: Unless otherwise provided, for purposes of this Contract, the term "days" shall
mean consecutive calendar days, including Saturdays, Sundays, and holidays, whether federal, state, local or religious. For the purposes
of calculating days, the count of "days" shall begin on the day following the day upon which any act or notice as provided in this
Contract was required to be performed or made. Any reference to a date or time of day shall refer to the date and/or time of day in the
State of North Carolina.
Buyer initials
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SC Seller initials
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THE NORTH CAROLINA ASSOCIATION OF REALTORS®, INC. AND THE NORTH CAROLINA BAR ASSOCIATION MAKE
NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY
SPECIFIC TRANSACTION. IF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT IT DOES NOT PROVIDE FOR YOUR
LEGAL NEEDS, YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN IT.
This offer shall become a binding contract on the Effective Date. Unless specifically provided otherwise, Buyer's failure to timely deliver
any fee, deposit or other payment provided for herein shall not prevent this offer from becoming a binding contract, provided that any
such failure shall give Seller certain rights to terminate the contract as described herein or as otherwise permitted by law.
Date: vt 2S 9Ok g
Buyer
Date:
Graham Hugh Diering
SO 2-S-/Zezq e
Buyer 7
Sarah Cohen
Entity Buyer:
Seller
1114e—
Date: it S b D.01
James Bartram
Date: o'�5 /
Seller /25 // g
Jane Bailey
Entity Seller:
(Name of LLC/Corporation/Partnership/Trust/etc.) (Name of LLC/Corporation/Partnership/Trust/etc.)
By: By:
Name: Name:
Title: Title:
Date: Date:
[THIS SPACE INTENTIONALLY LEFT BLANK]
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NOTICE INFORMATION
NOTE: INSERT AT LEAST ONE ADDRESS AND/OR ELECTRONIC DELIVERY ADDRESS EACH PARTY AND AGENT
APPROVES FOR THE RECEIPT OF ANY NOTICE CONTEMPLATED BY THIS CONTRACT. INSERT "N/A" FOR ANY WHICH
ARE NOT APPROVED.
BUYER NOTICE ADDRESS:
SELLER NOTICE ADDRESS:
Mailing Address: Mailing Address:
Buyer Fax#: Seller Fax#:
Buyer E-mail: Seller E-mail:
SELLING AGENT NOTICE ADDRESS: LISTING AGENT NOTICE ADDRESS:
Firm Name: NA Firm Name: Keller Williams Realty United
Acting asp Buyer's Agent❑ Seller's (sub)Agent [Dual Agent Acting as ❑ Seller's Agent 0 Dual Agent
Firm License #: Firm License #: 71111
Mailing Address: Mailing Address: 101 Cosgrove Ave Ste 200, Chapel
Hill, NC 27514-5277
Individual Selling Agent: NA Individual Listing Agent: Margaret Hung
❑ Acting as a Designated Dual Agent (check only if applicable) ❑ Acting as a Designated Dual Agent (check only if applicable)
Selling Agent License #: Listing Agent License #: 210528
Selling Agent Phone#: Listing Agent Phone#: [phone]
Selling Agent Fax#: Listing Agent Fax#: [phone]
Selling Agent E-mail: Listing Agent E-mail: fl /11i& & & IC(J. Coil
[THIS SPACE INTENTIONALLY LEFT BLANK]
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ACKNOWLEDGMENT OF RECEIPT OF MONIES
Seller: James Bartram, Jane Bailey ("Seller")
Buyer: Graham Hugh Diering, Sarah Cohen ("Buyer")
Property Address: 410 Whitehead Cir, Chapel Hill, NC 27514-4833 ("Property")
i0 LISTING AGENT ACKNOWLEDGMENT OF RECEIPT OF DUE DILIGENCE FEE
Paragraph 1(d) of the Offer to Purchase and Contract betweeajluyer and Seller for the sale of the Property provides for the payment to
Seller of a Due Diligence Fee in the amount of $ /0 000 xt , receipt of which Listing Agent hereby acknowledges.
Date:
Firm: Keller Williams Realty United
By:
(Si re)
Marge Hung
(Print name)
zi SELLER ACKNOWLEDGMENT OF RECEIPT OF DUE DILIGENCE FEE
Paragraph 1(d) of the Offer to Purchase and Contrac between dyer and Seller for the sale of roperty provides for the payment to
Seller of a Due Diligence Fee in the amount of $ �(% 00 0 , receipt of which Sereby acknowledges.
Date
Date
:t 5' Play ao)
Seller:
Seller:
(Signature)
�a Bertram
(Signature)
Jane Bailey
❑ ESCROW AGENT ACKNOWLEDGMENT OF RECEIPT OF INITIAL EARNEST MONEY DEPOSIT
Paragraph 1(d) of the Offer to Purchase and Contract between Buyer and Seller for the sale of the Property provides for the payment to
Escrow Agent of an Initial Earnest Money Deposit in the amount of $ . Escrow Agent as identified in Paragraph
1(f) of the Offer to Purchase and Contract hereby acknowledges receipt of the Initial Earnest Money Deposit and agrees to hold and
disburse the same in accordance with the terms of the Offer to Purchase and Contract.
Date
Firm: Bagwell Holt Smith P.A.
By:
(Signature)
(Print name)
❑ ESCROW AGENT ACKNOWLEDGMENT OF RECEIPT OF (ADDITIONAL) EARNEST MONEY DEPOSIT
Paragraph 1(d) of the Offer to Purchase and Contract between Buyer and Seller for the sale of the Property provides for the payment to
Escrow Agent of an (Additional) Earnest Money Deposit in the amount of $ . Escrow Agent as identified in
Paragraph 1(f) of the Offer to Purchase and Contract hereby acknowledges receipt of the (Additional) Earnest Money Deposit and agrees
to hold and disburse the same in accordance with the terms of the Offer to Purchase and Contract.
Date
Firm: Bagwell Holt Smith P.A.
Time: ❑ AM ❑ PM By:
(Signature)
(Print name)
Page 13 of 13
Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 w tamest Loaix-com
STANDARD FORM 2-T
Revised 7/2017
© 7/2017
Cohen-Diering

North Carolina Department of Environmental Quality
Division of Water Resources
PERMIT NAME/OWNERSHIP CHANGE APPLICATION FORM
I. INSTRUCTIONS
1. Complete this form in its entirety as follows:
(a) Change of Ownership — Provide the information in Parts II and III and submit legal documentation of the
transfer of ownership such as a contract, deed, article of incorporation, etc. The certifications in part IV
must be signed by both the current permit holder, if available, and the new applicant(s).
(b) Name Change Only — Provide the information in Parts II and III. Sign the certification for the new
applicant in part IV.2.
2. Submit the properly completed form to the address on bottom of Page 2.
II. CURRENT PERMIT INFORMATION
1. Permit Number: WI0500414
2. Permittee name(s): James Bartram and Jane Bailey
3. For Business/Governmental Agency- Permit signing official's name and title:
(Person legally responsible for permit)
4. Mailing Address: 410 Whitehead Circle
City: Chapel Hill
State: NC Zip: 27514
Telephone number: ( ) Fax number: ( )
EMAIL Address: [e-mail]
5. Physical Address of Facility/Well(s) (if different than mailing address)
Same as above
City: County: Zip:
III. NEW OWNER / NAME INFORMATION
1. This request for a permit change is a result of:
X a. Change in ownership of property/company
b. Name change only
c. Other @lease explain):
Permit/Name Change of Ownership Form Rev. 2-18-2020 Page 1

2. New Owner's name(s) as listed on the property deed (Please Print/or Type):
Sarah Cohen and Graham Diering
3. If Business or Governmental Agency- Permit signing official's name and title:
(Person legally responsible for permit)
4. Mailing Address: 410 Whitehead Circle
City: Chapel Hill State: NC
Day/Cell Phone No. (_301 ) 310-3096 Fax number:
EMAIL Address: [e-mail]
Zip: 27514
IV. CERTIFICATION
1. Current Permittee's Certification (Please print or type):
I, , attest that this application for name/ownership change has been reviewed
and is accurate and complete to the best of my knowledge. I understand that if all required parts of this
application are not completed and that if all required supporting information and attachments are not included,
this application package will be returned as incomplete. I understand I will continue to be responsible for
compliance with the current permit until a new permit is issued.
2. New Applicant(s)'s Certification (Please print or type):
I/We, Sarah Cohen and Graham Diering
attest that this application for name/ownership change has been reviewed and is accurate and complete to the
best of my knowledge. I understand that if all required parts of this application are not completed and that if all
required supporting information and attachments are not included, this application package will be returned as
incomplete. I further certify that I will operate and maintain the permitted facility in accordance with the permit
and related regulatory requirements.
Signature:
Signature:
44,
/4..a./ta-kn.
Date: 08/09/21
Date: 08/09/21
SUBMIT THE COMPLETE APPLICATION PACKAGE VIA ONE OF THE FOLLOWING METHODS:
U.S. Postal Service: Courier / Special Delivery / In Person:
Ground Water Resources Section
NC Division Of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636
Ground Water Resources Section
NC Division Of Water Resources
512 North Salisbury Street
Raleigh, NC 27604
Telephone Number: [phone]
Permit/Name Change of Ownership Form Rev. 2-18-2020
Page 2