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HomeMy WebLinkAboutBC11-08-SULLIVANBrunswick County BC11-08 Local Government Permit Number CAMA MINOR DEVELOPMENT PERMIT i i 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 John Sullivan, authorizing development in the Estuarine Shoreline (AEC) at 3570 Norman Drive SW, in Supply NC 28462, as requested in the permittee's application, dated 26-Jul-11. This permit, issued on 15-Aug-11, is subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void. This permit authorizes: 40' x 10' Open Uncovered Deck/Fill Dirt/Grading/Stump Removal (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received on 26-Jul-11. (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, or land use activities will require a re-evaluation and modification of this permit. (4) A copy of this permit shall be posted or available on site. Contact this office at 910.253.2034 for a final inspection at completion of work. RECEIVED (Additional Permit Conditions on Page 2) DCM WILMINGTON, NC 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: DECEMBER 31, 2014 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 another party without the written approval of the Division of Coastal Management. AUG 1 8 2011 I - Connie Marlowe CAMA LOCAL PERMIT OFFICIAL PO Box 249 Bolivia NC 28422 PERMITTEE (Signature required if conditions above apply to permit) Name: John Sullivan Minor Permit # BC11-08 Date: 15-Aug-11 Page 2 (5) The amount of impervious surface shall not exceed 30% of the lot area within 75 feet of Normal High Water (Estuarine Shoreline Area of Environmental Concern), in this case, 20 square feet is authorized. (6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all development/construction shall be located a distance of 30 feet landward of Normal High Water. No portion of the roof overhang shall encroach into the 30 ft. buffer. (7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area has been properly stabilized with a vegetative cover. (8) Any proposed grading within the 30' buffer from the Normal High Water must be contoured to prevent additional stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remain in a vegetated state. (9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction completion. RECEIVED DCM WILMINGTON, NC. AUG 1 8 2011 SIGNATURE: �' DATE: PERMITTEE Locali tY.O � tu`t ° i ck- Ocean Hazard Estuarine Shoreline ORW Shoreline _ (For (% icial use only,) GENERAL INFORMATION LAND OWNER ffie'q Name % / <l L� (d�' Gc/Il`c Address ~% %� %� � ✓ 4 Permit Number Public Trust Shoreline Otlier T(,.,v Pa�cd �3ub6o6-�)P City 16 � d��_ State ZiP , a"Aone Email AUTHORIZED AGENT Name Address City _ Email State Zip _ Phone :Kr+ev 40 9 99k ) LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the adjacent waterbody.) r t 67 .tJ/l�ao� //I DESCRIPTI N OF PROJECT: (List all proposed construction and land disturbance.) — Peck 4 O Fly , R"Mo'�'(`f��a�rrrq (lb SIZE OF LOT/PARCEL: < Fsquare feet acres 1,� Y 3 $�i � d PROPOSED USE: Residential Eg" (Single-family Multi -family Commercial/Industrial M Other COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies to your property): (1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but excluding non -load -bearing attic space) (2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT UPON SURFACES: 2_o square feet (includes the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.) STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater Management Permit issued by the NC Division of Water Quality? YES NO_JZ' If yes, list the total built upon area/impervious surface allowed for your lot or parcel: RECEIVED JUL 2 8 2011 square feet. RECEIVED UUL162011 OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor development 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 Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and others. Check with your Local Permit Officer for more information. STATEMENT OF OWNERSHIP: I, 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 CAMA 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) ( -2a - ;l 11 i'1 C t�ll ir44 n V an owner or record title, Title is vested to ,see Deed Book a .74�� page J in the ��Jl.✓Yd" County R gistry of Deeds. an owner by virtue of inheritance. Applicant is an heir to the estate of probate was in County. if 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. (1) (2) (3) (4) ACKNOWLEDGEMENTS: RECEIVED I, the undersigned, acknowledge that the land owner is aware that the proposed development is lamed for an area which may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer hW p aL20$1 me the particu- lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza- tion and floodproofing techniques. r)CM WILMINGTON, NC I furthermore certify 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 i day of , 20 Landowner or person authorized to act as his/her agent for purpose of filing a CAMA permit application This application includes: general information (this form), a site drawing as described on the back of this application, the ownership statement, the Ocean HazardAEC Notice where necessary, a check for $100.00 madepayable to the locality, and any information as may be provided orally by the applicant. The details of the application as described by these sources are incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of any permiflDdeveloping in an AEC without permit is subject to civil, criminal and administrative action. JUL A 4 2011 91 DR 9"�y 80.00' E.C. WALL 5UBDIV1510N FIEF MC 2 1 /2 PAGE 137 LOCKWOOD COUW 51tUN5WICK COUNTY, N.G. 5CALC I'- 30' MAY 26. 201 I 0 15 30 60 5 84° 1 7' 19'E.78AW rROr�RTY UN! rtK MC 2 1/2 fA( . ' b 137 LITTLE .Sh1ALLOTTE (V RIVER N U �. yor Or aWK 1 • ear I e✓� . I S 8 I °4.}5"E 78.8g,� i � I h r I Operl-uAcovt e41 ProporJ (>% k I 27,---�1R'oea,� 2 551NOLE to ' 2 Z I d A m a i '1 t�L iY t YO rr�` FEIS 7C1. m `I, 1•I/4 elr 5 82045 pa-0 d 20 /, pr 24.38, N 79"50' 15 "�►i N Bp,G �, 17 31" �r "w !� RECEIVED UUL.2 B 2111 Elo �r u m CC` EIVEW JUL 2 7 2011 m WILMINGTON, NC 20, INGRE5$ # EGI�55 I OB G44'823 �a gar car E.C. WALL 5UBDIV151UN REF MC 2 112 PAGE 137 LOCKWOOD rOMW MUN5VACK COUNTY. N.G. 5CALC 1 *- 30 tAAY 26. 201 t_.__ Q I g 30 GO Wisp l �. 5 84°171190C 78.46' ON `NO10NIWIIffi &Nit] rRprCRTY UNE PM MC 2 1/2 1.37 ui LITTLE SHALLOTI"E RIVER `I' $ uoz s Z inr 11Ltn !1L ror OF 5A AIL ` Z ®3 A 13 0 3 1 Gr" 5 81 °44� 78.86' 1.1/4 Elr 5 82°45 Ue —7 8lNC,U' th tV a Q Ark 0). 1. 1 1 lea rr NTEL rtb9 0 DR 20' INGRE55 # EGRE55 ' r D8 644-823 ' 9y �'00 �A24.38' N 79°5a15%V e y .N17W 55.46' 'Ne 2�29`75 74' �a ��e Date F Day I L"lAf:--Rboin:50rl Adjacent Property Owner M ding Address t t PR i�—t)C_ 1Y yiv'� City, State, Zip Code Dear Adjacent Property: This letter is to inform you that I, Property Owner Postal Service — CERTIFIED • • r- foomestic Mail Only; Ln . R 5►� i "; y /raI(Endorswient ostage S.- 1 rn ad FeePostmalh pV Foe Herequired)ery Feequlretl) to -- t o t �. Total Postage &Fees � t ru t 1 11� ii !Ki ^ C 7� / t of o V i .i�l.� »......)__.:� (Y t J__V { 1 O 9ireet. Apt NBOX . 131 i) ` 4 3 0611 t j, elf Jll� ciry, sire, air : Q (� 1 t• iN�� Z 14 14).2. Permit on my property at �`1 ZY 4& 2 %v Z 3y, , 2 , in COUNTY Property Address County. As required by CAMA regulations, I have enclosed a copy of my permit applicatiln and project drawing(s) as notification of my proposed project. No action is required from you or you may sign and return the enclosed no objection form. If you have any questions or comments about my proposed project, please contact meat �O-= -�:7/4- or by mail at the address listed below. If you wish to Applicant's Telephone file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit them to: LPO NAME Local Permit Officer for LOCAL GOVERNMENT LOCAL GOVERNMENT ADDRESS CITY, STATE, ZIP CODE Since , P rty Owner :Z& /r��rrl Mailing Address City, State, Zip Code R fCAWEIVED JUL 2 7 2011 f` 4J� WILMINGTON, NC — Oti�Y�I ate lAdNer'brrk- C . �lctind "�r 0�t o,ey Owner fylailing Addre--� City, State, Zip Code Dear Adjacent Property: Postal CERTIFIED MAIL- w • rL f A Coverage Ln ,,u :AL r7 rt Postage $ M Certified Fee M C3 Ratum Receipt Fee (Endorsement Required) I Postmark Here t3 Restricted Delivery Fee (Endorsement Required) O m Total Postage &Fees $, flJ C3 cr (f C. F-) io, t� r _ _�_ SYreet Apt )Vo.;. .......................... er PO Box No. �� j j �'{ (� ........U-.- �---•---_- A I tUC. A LQ,`£. q This letter is to inform you that I, Z �:S; vi ^%have applied for a CAMA Minor Property Owner Permit on my property at --25-- Za r �L—Z— f�'� / = — in COUNTY Property Address ' County. As required by CAMA regulations, I have enclosed a copy of my permit application and project drawing(s) as notification of my proposed project. No action is required from you or you may sign and return the enclosed no objection form. If you have any questions or comments about my proposed project, please contact me at ,or by mail at the address listed below. If you wish to Applicant's Telephone file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit them to: LPO NAME Local Permit Officer for LOCAL GOVERNMENT LOCAL GOVERNMENT ADDRESS CITY, STATE, ZIP CODE Sincerel Prog ,Owner Mailing Address City, State, Zip Code ,r- RECEIVED JUL 2 7 2011 DCM WILMINGTON, NC: IIIIIIII1118111IIII�IIIIIIIII11111 g315� Pi3as °3-25-z6'e� 8runsuick Count Brenda �. ClemmoPROP Y. N C Register of Deeds papa 1ns of 2 Brenda n. Cl"-M Register of Deeds A4-Bb-2011 13:21:26.090 Brunsui ck County, NC N VENUE STAftP; $216.00 (n254616) �q n Q Total V GX $ C: �Si, ea5 $ RBtU00: __� GK_Fnarlw ❑PO aKut'lWage,naror.yicJ t.toC(114wn otonQ��a. ❑()OCU1T°'d "O�"R^F. pAIf A^KN!tly0!�R� ' inyiON:rel u�c:.;n'mUl :•..tLrtH;U�dIX CdOiBd ?gin STATE OF NORTH CAF&INA r=, GENERAL WARRANTY DEED REVENUE STAMPS: $ 2113 PARCEL#: 2300006003 DRAWN BY AND KIRBY LAW FIRM, PLLC RETURNED TO: KIRBY JxAW FIRM, PLLC Brief Legal: Lot.5, E.C."1WaU;Subdivision This deed, made and entered into this day, of /or P,? L 2011 by and between BPLC, Ill LLC, a North Carolina Limited Liability Company (mailing address. 90 Box dql` (a/ca,5hom NL arf z`i , the Grantors, and John C. Sullivan and wife Brenda K. Sullivan, the Grantees, whose address is: 711 Tatum Road, Shallotte NC 28470 WITNESSETH, that the Grantor for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these� presents does grant bargain, sell and convey unto the Grantee in fee simple, affthat certain` g{fspppei of land located in the county of BRUNSWICK, State of NORTH DAROLIN'X pore partl"a(d l ribed as follows: Being all of hot 5 as shown by survey and'plat made H.R. Hewitt dated October 10, 1945 and recorded in Map Book 1 % Page 137 in the Register of Deeds Office in Brunswick County North Carolina. This is the identical property conveyed to James D. Coble by deed of Sarah Dianne Smith, Caroline V. Smith, Rebecca S. Williams and her husband Douglas R. Williams dgjed January 9, 1987 and recorded January 20, 1987 in the Office ojthe Brunswick Clnry Regist� of Deeds in Deed Book 678 at page 748. Together with those ease; s for iy ess e e l ress and over and upon those certain easements as set in DeeiA'� ok 636 at pagJ and in Deed Book 834 at Page 1051 of the Brunswick County Regtis The property herein conveyed is not the primary residence of the Grantor. To have and to hold the aforesaid lot or parcel, together with all privileges and appurtenances thereto, heretofore belonging to the Grantor in fee simple. The Grantor covenants with the„Grantee, that tt°°tAr}tlr is seized of the premises in fee simple, has the right to convey tfie same I' (fie simple, t{T4f 19�k-�itle is marketable and free and clear of all encumbrances, an that Granto" arrant and defend the title against the lawful claims of all persons whomever except for the exceptions hereinafter stated. Title to the property hereinabove described is subject to the following exceptions: The provisions of all applicable zoning and land use ordinances, statutes and regulations; 2011 ad valorem taxes, and all applicable restrictive covenants and utility easements of record. In witness whereof the Grantor has hereunto set his hand and seal, or if corporate, has caused this instrument to be signed in its corporate name by- its duly authorized officers and its seal to be hereunto affixed by authority ?its Board of DirectcieB ihR daX_ and year first above written. �wit.,EIVED JUL 2 7 2011 - _ - -ab ; 'NiQWN, NC Simpson, Shaun From: Connie Marlowe [cmarlowe@brunsco.net] Sent: Wednesday, July 27, 2011 9:01 AM To: Simpson, Shaun Subject: FW: CAMA Minor Permit Application Attachments: doc01082320110727080218. pdf Attached is John Sullivan (BC11-08) CAMA Minor Permit Application. Septic Permit is not attached as the system was approved in 1985 and I was unable to locate a copy of the permit in the system. Connie Marlowe Brunswick County Planning & Community Development PO Box 249 75 Courthouse Drive NE Bolivia NC 28422 910.253.2034 or 800.621.0609 910.253.2437 (F) www.brunswickcountync.gov -----Original Message ----- From: info(@brunsco.net jmailto:info(@brunsco.netl Sent: Wednesday, July 27, 2011 9:02 AM To: cmarloweRbrunsco.net Subject: ------------------- CS 520i [00:c0:ee:4c:49:67] ------------------- RECEIVED DCM WILMINGTON, NC JUL 2 6 'All 1 CAMA PERMIT NOTICE Pursuant to NCGS 113A-119(b), Brunswick County, a locality authorized to issue CAMA permits in areas of environmental concern, hereby gives NOTICE that on 26-Jul-11 John Sullivan applied for a CAMA minor development permit to construct a 40' x 10' Open Uncovered Deck at 3570 Norman Drive, in Supply NC 28462. The application may be inspected at the address below. Public comments received by 12-Aug-11 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. Connie Marlowe CAMA Local Permit Officer for Brunswick County PO Box 249 Bolivia, NC 28422 Phone (910) 253-2025 PLEASE PUBLISH ON 03-Aug-11 RECEIVED JUL 2 7 2011 DCM WILMINGTON, NC J CAMA PERMIT NOTICE Pursuant to NCGS 113A-119(b), Brunswick County, a locality autho- rized to issue CAMA permits in areas of environmental concern, hereby gives NOTICE that on 26-Jul-11 John Sullivan applied for a CAMA minor development permit to construct a 40' x 10' Open Uncovered Deck/Fill Dirt/ Grading/Stump Removal at 3570 Nor- man Drive, in Supply NC 28462. The application may be inspected at the address below. Public comments re- ceived by 12-Aug-11 will beconsidered. 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 de- cision in this matter will be provided upon written request. Connie Marlowe CAMA Local Permit Officer for Brunswick County PO Box 249 Bolivia, NC 28422 Phone (910) 253-2025 Aug. 4 STATE OF NORTH CAROLINA COUNTY OF BRUNSWICK C t 1, 0 8 AFFIDAVIT OF PUBLICATION Before the undersigned, a Notary Public of said County and State, duly commissioned, qualified, and authorized by law to administer oaths, personally appeared Scott R. Harrell who, being first duly sworn, deposes and says: that he is Publisher (Owner, partner, publisher, or other officer or employee authorized to make this affidavit) of The Brunswick Beacon, a newspaper published, issued, and en- tered as periodical mail in the Town of Shallotte in the said County and State; that he is authorized to make this affidavit and sworn state- ment; that the notice or other legal advertisement, a true copy of which is attached hereto, was published in The Brunswick Beacon on the following date(s): August 4, 2011 and that the said newspaper in which such notice, paper document or legal advertisement was published, was at the time of each and every such publication, a newspaper meeting all the requirements and qualifications of Section 1-597 of the General Statutes of North Carolina and was a qualified newspaper within the meaning of Sec- tion 1-597 of the General Statutes of North Carolina. This the 4th day of August, 2011. .............Xaturer.�L.../ ................. (Sigf person making affidavit) Sworn to and subscribed before me this 4th day of August, 2011. ............ . ......... (Notary Public) RE"(';- E I V E D My commission expires: December 29, 2014. SEP 0 9 2011 DCid1 WILMINGTON, NC CAMA Minor Permit I Log 2011-2012 Brunswick County Wiro / Pg. 1 Date Quarterly report received: 9-26-11 1 st Quarter Permit No. Applicants Name Project Location Date RO received App. Date on App. Date RO received Permit Date of permit Decision Date App. Filed Date RET rcv'd Public Notice AEC App Complete A ppr. for Payment 11-06 Fauver, Ellen 2060 Sea Aire Canal SW 7/5/11 7/5/11 8/3/11 7/19/11 7/5/11 7/5/11 n/a Y Y 11-07 McLelland 3583 River View Ln 7/25/11 7/8/11 11/15/11 8/12/11 7/25/11 7/25/11 n/a Y Y 11-08 Sullivan, John 3570 Norman Dr 7/28/11 7/26/11 8/18/11 8/15/11 7/26/11 7/27/11 n/a Y Y 11-09 Riverbend Shallotte LLC 1306 Riverbend Dr 8/4/11 8/2/11 8/24/11 8122/11 8/2/11 8/4/11 n/a Y Y 11-101 Ludlum, Curtis 2784 Sea Vista Dr 8/9/11 8/5/11 9/12111 8/23/11 8/5/11 8/9/11 n/a Y Y 11-10MOD Ludlum, Curtis 2784 Sea Vista Dr 8/9/11 8/5/11 9/12/11 n/a Y N 11-11 Ludlum, Curtis 2784 Sea Vista Dr 9/21/11 9/21/11 9/22/11 n/a Y carry over LPO COMPOSITE RECORD FORM FOR MINOR PERMITS LOCALITY: Brunswick County FOR QUARTER: July - September Year: 2011 T � 4% C C E C V 7 O Ur N _N N W U) c > Ch � E o W ` Q' @ W a W LL. File # Applicant Name Project Address v C O c cb .� 7 .0 y M N = O U- . O 'a+ Z N C O_ 6 N = O U- U N H Q w y g m ( a Q cn o = Q m E c. 0 0 0 0 �, w 0 a 0' a� a N L o y U a. in p p � 2 cn 1— Of U BC11-06 Ellen Fauver 2060 W. Sea Aire Canal, Supply NC 5-Jul-11 7-Jul-11 13-Jul-11 19-Jul-11 ES 12' x 10' Addition BC11-07 Ronald McLelland 3583 River View Lane SW, Supply NC 8-Jul-11 27-Jul-11 3-Aug-11 12-Aug-11 ES Ex and Screened Porch BC11-08 John Sullivan 3570 Norman Drive, Supply NC 26-Jul-11 3-Aug- 11 3-Au -11 15-Aug-11 ES 40' x 10' Deck, Fill, etc. Riverbend Shallotte LLC BC11-09 (%Dr. James Morphis, Jr.) 1306 Riverbend Drive SW, Shallotte NC 2-Aug-11 10-Aug-11 3-Aug-11 22-Aug-11 ES Pool w/deckin & 4' fence BC11-10 Curtis Ludlum 2784 Sea Vista Drive SW, Supply NC 5-Aug-11 10-Aug-11 10-Aug-11 23-Aug-11 ES Pool w/deckin & 4' fence Return To: Division of Coastal Management 127 Cardinal Drive Ext R. EEIN/ED Signature: C f larloWLI, -V1. ( Ill! (j VV` - Date: 26-Sep-11 Wilmington NC 28405 SEP 2 0 2011 Phone Number : 910,253.2034 DCM WILMING'TON, INC REQUISTION FOR PAYMENT OF CAMA MINOR PERMIT PROGRAM IMPLEMENTATION AND ENFORCEMENT Local Government:c Period Covered: X l' Quarter (July - Aug - Sept) FY: 2011-2012 2nd Quarter (Oct - Nov - Dec) 3rd Quarter (Jai - Feb - Mar) 4d` Quarter (Apr - May - Jun) Services Rendered: OH ES = Permits processed @ $55.00 each (Cities and towns) OH ES = J Permits processed @ $75.00 each (Counties) OH_ ES = Final Inspections @ $40.00 each OH ES = Exemptions investigated @ $25.00 each OH ES / _ _� Violations resolved @ $100.00 each LPO Training (not to exceed $200.00) TOTAL AMOUNT REQUESTED UNDER THIS REQUISITION $ �co.0v � pU 4- 76 The above information is an accurate account of activities carried out by the local government staff during the period specified above. I approve for paym t. --� DCM Regional Repr entative Date: DATE RCVD IN WILMINGTON OFFICE: L'j d4 —/ / DATE SENT TO MOREHEAD CITY OFFICE: DATE PAID: