44-22 Town of EI receipt

s 0
Received From:
WroMIMN
Applicant's Name: Tows !3 P-
Project Address:
NC Division of Coastal Management
Cashier's Official Receipt
20217 A B�jn
Date: — A2-
Check No.: 66&
County: L r���e�
Please retain receipt for your records as proof of payment for permit issued.
Signature of Agent or Applicant:
Signature of Field Representative:
Date:
Date: �✓'