NTB_13-17_ Thompson

Issued by WiRO
North Topsail Beach
L�F 3-11 ZbZ2
,AMvv
CAMA
MINOR DEVELOPMENT
PERMIT
NTB13-17
Permit Number
as authorized by the State of North Carolina, Department of Environment,
and Natural Resources and the Coastal Resources Commission for development
in an area of environment concern pursuant to Section 113A-118 of the
General Statutes, "Coastal Area Management"
Issued to Donald C. Thompson authorizing development in the Ocean Hazard (AEC) at 4284 Island Drive, in North
Topsail Beach, Onslow County as requested in the permittee's application, dated April 15, 2013, and received by DCM
on April 15, 2013. This permit, issued on May 29, 2013, is subject to compliance with the application and site drawing
dated received on May 7, 2013 (where consistent with the permit), all applicable regulations and special conditions and
notes set forth below. Any violation of these terms may subject the permittee to a fine, imprisonment or civil action, or
may cause the permit to be null and void.
This permit authorizes: Construction of a single family residence.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received by DCM on May 7, 2013.
(2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations,
applicable local ordinances and FEMA Flood Regulations.
(3) Any change or changes in the plans for development, construction, and/or land use activities will require re-evaluation and
modification of this permit.
(4) A copy of this permit shall be posted or available on site throughout the construction process. Contact this office at (910)
766-7221 for a final inspection at completion of work.
U- EIVED
(Additional Permit Conditions on Page 2) DCM WILMINGTON, NC
JUN 0 3 2013
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of the issuing date. From the date of an appeal, any
work conducted under this permit must cease until the appeal is resolved. This
permit must be on the project site and accessible to the permit officer when the
project is inspected for compliance. Any maintenance work or project
modification not covered under this permit, require further written permit
approval. All work must cease when this permit expires on:
December31, 2016
Jason Dail
AL PERMIT OFFICIAL
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
In issuing this permit it is agreed that this project is consistent with the local Land
Use Plan and all applicable ordinances. This permit may not be transferred to
annthpr nnrtv withnitt the written annrnvnl of the nivicinn 4 Coastal

Name: Donald C. Thompson
Minor Permit # NTB13-17
Date: May 29, 2013
Page 2
(5) The structure(s) must be set back a minimum of 60 feet from the first line of stable natural vegetation, as determined
by the DCM.
(6) The permittee is required to contact the Local Permit Officer [phone], shortly before he plans to begin
construction to arrange a setback measurement that will be effective for sixty (60) days barring a major shoreline
change. Construction must begin within sixty (60) days of the determination or the measurement is void and must
be redone.
(7) All buildings constructed within the ocean hazard area shall comply with the NC Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Flood Damage
Prevention Ordinance as required by the National Flood Insurance Program. If any provisions of the building code
or a flood damage prevention ordinance are inconsistent with any of the following AEC standards, the more
restrictive provision shall control.
(8) All buildings must be elevated on pilings with a diameter of at least 8 inches in diameter if round, or 8 inches to a
side if square; and the first floor level of the sills and joists must meet the 100-year flood level elevation.
(9) All pilings shall have a tip penetration greater than eight (8) feet below the lowest ground elevation under the
structure. The deck shall be constructed independently from the residence and shall be structurally detached.
(10) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective
sedimentation and erosion control measures. Disturbed areas shall be vegetatatively stabilized (planted and
mulched) within 14 days of construction completion.
(11) Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structure(s) shall be relocated or dismantled within two years of the time
when it becomes imminently threatened and in any case upon its collapse or subsidence. However, if natural
shoreline recovery or beach renourishment takes place within two years of the time the structure becomes
imminently threatened, so that the structure is no longer imminently threatened, then it need not be relocated or
dismantled at that time. This condition shall not affect the permit holder's right to seek authorization of temporary
protective measures allowed under CRC rules.
(12) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise
disposed of to a third -party.
(13) The total floor area of the permitted dwelling shall not exceed 3,000 square feet, as staKierI0work
plan drawings.
DCM WILMINGTON, NC

' 2 I THER PERMITS MAY BE REQUED: The activity you are planning may require permits other than the CAMA
Pennit lumber J (minor HZdevelopment permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
iazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
/For official use only/ others. Check with your Local Permit Officer for more informatiou.
Lai. 1NFOR31AfION
DWNER
konald C. Thompson
445 Western Blvd Suite N
itsonville State Nc
[e-mail]
Zip 29546 Phone [phone]
)RIZED AGENT
State Zip Phone
'ION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
: waterbody.) 4284 Island Dr, North Topsail Beach. Atlantic Ocean
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a LAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
Dan owner or record title,'ritle is vested in 4284 Island Dr. , see Deed Book 2895
page 91 in the Onslow County Registry of Deeds.
IIan owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County,
=f other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. i affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name)
(1) Anne L. Kifer
(2) Ocean Ridge Village Homeowners Association
(3) Donald C. Thompson
tIPTION OF PROJECT: (List all proposed construction and land disturbance.) Construct single family dwelling (4)
F LOT/PARCEL: square feet .30 acres
►SED USE: Residential Q (Single-family ❑� Multi -family ) Commercial/Industrial ❑ Other
LETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer Jvou are not sure which AEC applies
property):
EAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: 3,000 square feet (includes
itioued living space, parking elevated above ground level, non -conditioned space elevated above ground level but
ig non -load -bearing attic space)
ASTAL SHORELINE AECs: SiZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
iURFACES: square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks,
e or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
ment Permit issued by the NC Division of Water Quality?
I NC=
ist the total built upon area/impervious surface allowed for your lot or parcel: square feet.
(Address)
4286 Island Dr.
Common Area
4290 Island Dr.
ACKNOWLEDGEMENT&
1, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. 1 acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerting stabiliza-
tion and floodproofing techniques.
1 furthermore cenify that i am authorized to grant, and do in fact grant, permission to Division of Coastal Management staff,
the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information
related to this permit application.
This the 15 day of AP61 20 13
,Doh& C. 711onfpJoh
Landowner or person authorized to act as his/her agent fir purpose of filing a CAMA permit application
This• application includes: general information /this limn), a site drawing as described an the hack (#'this application, the
ownership.statement, the Ocean HazanlAEC Notice where necessary, a check for 5100.00 made payable to the locality. and
arq information as may he provided orally by the applicant. The details of the application as• described by these sources are
incorporated without reftrence in any permit which may he issued. Deviation front these details will constitute a violation of
am• permit. AMr persa+ developing in a+AEC' without permit is subject to civil, criminal atd ahninistralive action.
��e°
ReG' G1GN, NG
1N
DGM �j1`M � r1►� �3

4
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
May 29, 2013
Mr. Donald C. Thompson
445 Western Blvd., Suite N
Jacksonville, NC 28546
Dear Mr. Thompson:
John E. Skvarla, III
Secretary
Attached is CAMA Minor Development Permit # NTB 13-17 for work to be done for at 4284 Island Dr.,
in North Topsail Beach, Onslow County.
In order to validate this permit, please sign both copies of the permit as indicated for our records.
Please retain the gold copy for your files and sign front and back of the white copy then return to us within
20 days of receipt, in the enclosed, self-addressed envelope.
This is not a valid permit until it is signed and returned to our office.
Thank you for your prompt attention to this matter.
Sincerely,
i
Shaun K. Sirup on
Permit Support Technician
Enclosures
cc: WiRO files
127 Cardinal Drive Ext., Wilmington, NC 28405
Phone: [phone] \ FAX: [phone] Internet: www,nccoastalmanagement.net

CAMA MINOR PERMIT NOTICE
Pursuant to NCGS 113A-119(b), the North Carolina Division of Coastal Management, an
agency authorized to issue CAMA permits in areas of environmental concern, hereby gives NOTICE
that on May 7, 2013, Donald C. Thompson proposed to construct a single-family dwelling at 4284
Island Drive, adjacent to the Atlantic Ocean, in North Topsail Beach, Onslow County. The application
may be inspected at the address below. Public comments received by May 24, 2013 will be
considered. Later comments will be accepted and considered up to the time of permit decision.
Project modifications may occur based on further review and comments. Notice of the permit
decision in this matter will be provided upon written request.
Jason Dail
Field Representative
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Phone: [phone]

NCDENR
North Carolina Department of Environment and Natura
Division of Coastal Management
Pat McCrory, Braxton C. Davis
Governor Director
May 8, 2013
[e-mail]
2 Pages
Star News
Legal Advertisement Section
Post Office Box 840
Wilmington, North Carolina 28402
Re: Donald C. Thompson Minor Public Notice
Resources
Kyle/Heather: Please publish the attached Notice in the Thursday, May 9, 2013 issue.
John E. Skvarla, III
Secretary
The State Office of Budget and Management requires an original Affidavit of Publication prior to
payment for newspaper advertising.
Please send the original invoice and a copy of the affidavit for payment to Shaun Simpson at Division of
Coastal Management, 127 Cardinal Drive Extension, Wilmington, NC 28405, 910-796-7226.
Paying by Credit Card (number on file with Elsa Lawrence, Ref acct # 796-7215). Please send a fax of the
credit card receipt to me.
Thank you for your assistance in this matter. If you should have any questions, please contact me at our
Wilmington office.
Sincerely,
Shaun Simpson
Permit Support Technician
Enclosure
cc: File Copy
Michele Walker - DCM
127 Cardinal Drive Ext., Wilmington, NC 28405

OCEAN HAZARD AEC NOTICE
Project is in an: X Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: OL ate C. iltoM{ o.i
Property Address: yXSN (Srq�,Q ar JOWLY 1'V,54i4- &VC-*f
Date Lot Was Platted: 3 �3 /I3
This notice is intended to make you, the applicant, aware of the
special risks and conditions associated with development in this
area, which is subject to natural hazards such as storms, erosion
and currents. The rules of the Coastal Resources Commission
require that you receive an AEC Hazard Notice and
acknowledge that notice in writing before a permit for
development can be issued.
The Commission's rules on building standards, oceanfront
setbacks and dune alterations are designed to minimize, but not
eliminate, property loss from hazards. By granting permits, the
Coastal Resources Commission does not guarantee the safety of
the development and assumes no liability for future damage to
the development. Permits issued in the Ocean Hazard Area of
Environmental Concern include the condition that structures be
relocated or dismantled if they become imminently threatened
by changes in shoreline configuration. The structure(s) must be
relocated or dismantled within two (2) years of becoming
imminently threatened, and in any case upon its collapse or
subsidence.
The best available information, as accepted by the Coastal
Resources Commission, indicates that the annual long-term
average ocean erosion rate for the area where your property is
located is 7feet per year.
The rate was established by careful analysis of aerial
photographs of the coastline taken over the past 50 years.
S lieselso indicate that the shoreline could move as much as
ZZ O feet landward in a major storm.
`h flppd waters in a major storm are predicted to be about
feet deep in this area.
Preferred oceanfront protection measures are beach nourishment
and relocation of threatened structures. Hard erosion control
structures such as bulkheads, seawalls, revetments, groins, jetties
and breakwaters are prohibited. Temporary sand bags may be
authorized under certain conditions.
The applicant must acknowledge this information and
requirements by signing this notice in the space below Without
the proper signature, the application will not be complete.
SPECIAL NOTE: This hazard notice is required for
development in areas subject to sudden and massive storms and
erosion. Permits issued for development in this area expire on
December 31 of the third year following the year in which the
permit was issued. Shortly before work begins on the project
site, the Local Permit Officer must be contacted to determine the
vegetation line and setback distance at your site. If the property
has seen little change since the time of permit issuance, and the
proposed development can still meet the setback requirement,
the LPO will inform you that you may begin work. Substantial
progress on the project must be made within 60 days of this
setback determination, or the setback must be re -measured. Also,
the occurrence of a major shoreline change as the result of a
storm within the 60-day period will necessitate re -measurement
of the setback. It is important that you check with the LPO
before the permit expires for official approval to continue the
work after the permit has expired. Generally, if foundation
pilings have been placed and substantial progress is continuing,
permit renewal can be authorized. It is unlawful to continue
work after permit expiration.
For more infortnWion, contact:
Local Permit Officer
Address
Locality
Phone Number
DCI�I,W44 !1�llijr:;�Ct NC
APR 1 0 t��3
Property Owner Signature Date

MAY 0 7 2013
I, CHAR[ Fc ARp FOOGS PROFESSIONAL LAND; `,¢ V �„1 IS TO CERTIFY THAT THE S1B.ECT PROPERTY IS LOCATED
SURVEYOR, DO HEREBY CERTIFY THAT I NAVE Y+� SO00 ZONE �E' MMICH IS A
SURVEYED THE PROPERTY AS SHOWN HEREON IH tKL' �SP-- FLOW HAZARD AREA AS DETERMINED BY THE FEDERAL
ACCORDANCE WITH THE STANDARDS OF PRACTISE r SEAL ERCEHCY MANAGEMENT AGENCY, AND THE NATIONAL FLOW
FOR LAND SURVEYING IN NORTH CAROLINA. THAT CE PROGRAM. COMMUNITY PANEL NUMBER
''y��TF� L-2981
THE RATIO OF PREP ON AS CALWLATm B2s i9 t n = 370488 372042]700J. NOVEMBER 3. 2005
LAP D D TURES f
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THIS AREA IS NOT EUGW BLE FOR FEDERAL FLOOD
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CHARLES F. RIGGS &
ASSOCIATES, INC. (c-73o)
LAND SURVEYING - CONVENTIONAL & GLOBAL POSITIONING SYSTEMS,
LAND PLANNING &
COMPUTER MAPPING
502 NEW BRIDGE STREET
P.O. BOX 1570
101 SCOTTS HILL LOOP ROAD
JACKSONVILLE. N.C. 26541-1570
WALMINGTON, N.C. 28411
TELEPHONE: [phone]
TELEPHONE: [phone]
FACSIMILE: [phone]
E-MAIL' riggsIcnddbIza rr.c0m
E-MAIL rigg9land0bi2m.m.cam
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$ P
8 NCNITro SKETCH
�$ BENCHMARK: NCGS MONUMENT 'DUNE AZMK'
NORTHING 27011INSA •
H3 EASING 2470388.89'
9 ELEVATION: 5.4'
ggg{ HORIZONTAL OATUY: MAD 83 (2011)
VERTICAL DATUM: NANO
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HORIZONTAL
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WITH TOPCON ORS USING N.C. GEODETIC
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PROP
452 S FL GARY C. THOMPSON t WFE
ly PROPOSED TOTAL IMPERUWS SURFACE - 2188 Sq.FL DAME F. THOMPSON
TOTAL LDT AREA -TOTS. S L
Ij PROPOSED IMPERVIOUS AREA - 20.3z nnr F;ierr
D.B. 2021, P. 142
O.B. 2895, P. BB
D.B. 2895, P. 91 LOT 27
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JOIL2I £ ETK - EXISTING PARKER-KALON NNL (FWNOXOONTRO
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MR. - MINIMUM BUILDING LINE
NMP - NON UMUMENTED PONT
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9P - SET IRON PIPE
MMRU SIR - SET IRON ROD
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SPK - SET PARKER-KALON MAIL (CONTROL COME
Opp •a &9 Q - CENTERLINE
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FIRE HYDRANT
- WATER VALVE
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(ELEVATION=18.0'+2') ®- CLEAN OUT
® - TELEPHONE PEDESTAL
®- TELEV190N PEDESTAL
® - FIBER OPTIC CABLE MARKER
la - LIGHT POE
POTTER POLE
POWER LINE
® - ELECTRIC TRANSFORMER
BOUNDARY SURVEY & PRELIMINARY PLOT PLAN
ILX•X - EXISTING SPOT ELEVATION
FOR
GRAPHIC SCALE
DONALD C. THOMPSON
GARY C. THOMPSON
& WIFE
t imh - 00 tt
DAVIE F. THOMPSON
ACTUAL FIELD SURVEY DATE: APRIL 3, 201
MAPPING DATE: APRIL 16, 2013
LOT 27, OCEAN RIDGE VILLAGE III
DRAWN BY: J. {-HELMS
STUMP SOUND TOWNSHIP, ONSLOW COUNTY, NORTH CAROLINA
CHECKED BY: C...N=. rz16;u5
4284 ISLAND DRIVE
FIELD BOOK: 792 PAGE: 25
PROJECT NUMBER: 13-03-24

r 1 41 4
No I 1 (00 ]A
AMA PERMIT
APPLIED FOR
. . • v -
. . . . - - - - - - - - - a -
- - - - - !VA -
Onslow County.
COMMENTS ACCEPTED THROU�,.
FOR MORE DETAILS CONTACT
THE LOCAL PERMIT OFFICER BELOW:
#r7w-3K4T-T-=, ljFMFMZM=��
iR. 07M. NeT9
Wilmington, NQ 2a405
Jason Dail, Field Representative
910-796-7215

0
0
■ Complete items 1, 2, and 3. Also complete
Item 4 If Restricted Delivery Is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to,
kit,
dM-11G
A. Signature
f ❑ Agent
XI
{... r rt�jf�yr:' t ❑Addressee
�Received by (Prinjed Name) C. Ite of q.�Irvery
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D. is delivery address different from item 17 ❑ Yes
ff YES, enter delivery address below: ❑ No
3. Se ice Type
10 Certified Mail ❑ Express Mail
❑ Reaistered ❑ Return Receiot for Merchandise
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Tansfer from service label) 7010 1870 0003 0478 2927
PS Form 3811, February 2004 Domestic Return Receipt
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
CG MG
aR V 41.4
a6 ax 44SS
F.-�►�d sum, ��
102595-02-M-1 W
A. Signature
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-❑ Agent
_ ✓.� t .l _) � '11+ ' t-' � b Addressee
B. Received by ( Printed Name) C. Date of Delivery
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D. Is delivery address different from Rem 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Se ice Type
lCertified Mail ❑ Express Mail
❑ Registered D Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
2. Article Number 70I0 18?0 0"�3 0478 2897
(rransfer from service label)

Dail, Jason
From: Dail, Jason
Sent: Thursday, April 18, 2013 8:25 AM
To: 'felixnegron@charter. net'
Subject: RE: [e-mail] has shared the 4284 Island Dr with you
Hey Felix,
I received your packet of information, but do not see any house design for this particular property. Unfortunately, in
order to issue a CAMA permit, there has to be a plan of development (i.e. house plan, driveway, parking, stormwater
system, pool, etc). If you can get me a house plan, including a profile view, along with a check for $100.00, 1 will begin
processing your application.
As always, please feel free to call if you have any questions.
Take care,
Jason
' Jason Dail
�! Field Representative
N.C.Division of Coastal Management
„ 127 Cardinal Drive Extension
tt' dmingtoit, NC 218 QQ�a.�
Ph- (1)10):r'�6�?;W
Fax: [phone]
'��"' � r �` Eaiaail:lason.d.�il�ucdertr.gov
-%,*W%%-.nccoastalinanage ntent.net
North Carolina Department of
uironn>eut and Natural Resources
*Please note that e-mail correspondence to and from this address may be subject to the North Carolina Public
records Law and may be disclosed to third parties.*
From: [e-mail] [mailto_echosi n echosign.com]
Sent: Monday, April 15, 2013 10:35 AM
To: Dail, Jason
Subject: [e-mail] has shared the 4284 Island Dr with you

AFFIDAVIT OF PUBLICATION
STATE OF NORTH CAROLINA
COUNTY OF NEW HANOVER
CAMA MINOR PERMIT NOTICE
Pursuant to NCG5 113A-119(b), the
North Carolina Division of Coastal
Management, an agency authorized
to issue CAMA permits in areas of
environmental concern, hereby
glues NOTICE that on May 7, 2013,
Donald C. Thompson proposed to
construct a single-family dwelling
at 4284 Island Drive, adjacent to
the Atlantic Ocean, in North Topsail
Beach, Onslow County. The applica-
tion may be inspected at the ad-
dress below. Public comments re-
ceived by May 24, 2013 will be
considered. Later comments will be
accepted and considered up to the
time of permit decision. Project
modifications may occur based on
further review and comments. No-
tice of the permit decision in this
matter will be provided upon writ-
ten request.
Jason Dail Field Representative
Division of Coastal Management
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
Phone: [phone]
11/%iwo✓ %1�rs Cam-- I�
Before the undersigned, a Notary Public of Said County and State,
Anita Thomas
Who, being duly sworn or affirmed, according to the law, says that he/she is
Publisher's Assistant
of THE STAR -NEWS, a corporation organized and doing business under the Laws of the State of
North Carolina, and publishing a newspaper known as STAR -NEWS in the City of Wilmington
CAMA MINOR PERMIT NOTICE Pursuant to NCGS 113A-119b, the North Carolina Division
of Coastal Management, an agency authorized to issue CAMA permits in areas of
environmental concern, hereby gives NOTICE that on May 7, 2013, Donald C. Thompson
proposed to c
was inserted in the aforesaid newspaper in space, and on dates as follows:
5/10 Ix
And at the time of such publication Star -News was a newspaper meeting all the requirements and
qualifications prescribed by Sec. No. 1-597 G.S. of N.C.
i
Title: Publisher's Assistant
S orn or affirmed to, and subscribed before me this % day of
A.D.,
In Te mony Whereof, I have hereunto set my hand and affixed r4ZrX�60
year aforesaid,
7 r, ou Jc- z^ is % ADAlL it eJ
o pUBI� �,
My commission expires day of , 20_ "j�
1 j.
Upon reading the aforegoing affidavit with the advertisement thereto annexed it is adjudged by the Court that the said
publication was duly and properly made and that the summons has been duly and legally served on the defendant(s).
This day of
MAIL TO:
Clerk of Superior Court
RECEIVE©
Dr—,M WILMING-7 )NJ, NC
MAY -,, ,013