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Home My WebLink AboutNH-11-028-MILLERNEW HANOVER COUNTY 11.028 Local Government Permit: Number T` MINOR DEVELOPMENT PERMIT 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 Ken Miller, authorizing development in the Estuarine Shoreline - ORW (AEC) at 8200 Bald Eagle Lane, in Wilmington, NC, as requested in the permittee's application, dated August 30, 2011. This permit, issued on September 19, 2011, 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: Construction of 192 square feet of decking (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received on August 30, 2011, (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 910-798-7118 for a final inspection at completion of work. RECEIVED DCM WILMINGTON, NC (Additional Permit Conditions on Page 2) SEP 2 0 2011 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: April 13, 2015 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. Christine R. ou and LAMA LOCAL PERMIT OF ICIAL 230 Government Center Drive, Suite 110 Wilmington, INC 28403 PERMITTEE (Signature required if conditions above apply to permit) Name: Ken Miller Minor Permit # 11.028 Date: September 19, 2011 Page 2 (5) The amount of impervious surface shall not exceed 25% of the lot area within 575 feet of Normal High Water (Estuarine Shoreline - ORW Area of Environmental Concern), in this case, no new impervious 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 for 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 SEP202011 SIGNATURE: RATE: PERMITTEE V/ Locality Plc pe Ocean Hazard Estuarine Shoreline re( Pi GENERAL INFORMATION LAND OWNER Name I<2 Y` M 1, 1/ e Permit Number ORW Shoreli � V P blic Trust Shoreline Other (For official only) RECEwu AuG 3 a xrt Address 02ZoU /LLS %( add— L", PI City %%��hn, +'��iT�✓1 State e Zip Z;;Vl Phone AUTHORIZED AGENT If Name %��ei.% �yt✓ � -, � o ,�' `f G-� .S�y��'e- (>� �� .. � � Address City t.'7 J State s Zip Phone %9 C/(a I LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of If, the adjacent waterbody?) 47 DJ DESCRIPTION OF PROJECT: (List all propose construction and land disturbance.) wt ce LyaCeX lj c7 � \ ✓lam �ti Gu1,�t 4-7, T' r t SIZE OF LOT/PARCEL: square feet e acres PROPOSED USE: Residential (Single-family Multi -family ) Commerical/Industrial jOther N( TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI- RONMENTAL CONCERN (AEC): r square feet (includes all floors and roof -covered decks) Ha SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. ft. (Calculations include 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.) Choose the AEC area that applies to your property: (1) within 75 feet of Normal High Water for the Estuarine Shoreline AECRECEIVED within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters SEP 14 2011 (3) within 30 feet of the Public Trust Shoreline AEC (Contact your Local Permit Officer if you are not sure which AEC applies to your proper- 1\A �« Nl M Gl O N , NC STATE STORMWATER MANAGEMENT PERMIT. Is the project located in an area subject to a State Stormwater Management Permit issued by the N.C. Division of Water Quality? YES NOS If yes, list the total built -upon area/impervious surface allowed for your lot or parcel. square feet. ITIJER PERMITS MAYBE REQUIRED: The activity you are planning may require permits other than the CAMA minor .velopment permit. As a service we have compiled a list of the kinds of permits that might be required. We suggest you check over the list ith your LPO to determine if any of these apply to your project: Zoning, Drinking Water Well, Septic Tank (or other sanitary waste eatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA Certification, tnd Dune, Sediment Control, Subdivision Approval, Mobile Home ParkApproval, Highway, Connection, and others. ►� 0 TATEMENT OF OWNERSHIP: i the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a :rson authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person ;ted as landowner on this application has a significant interest in the real property described therein. This interest can be !scribed as: (check one) n an owner or record title. Title is vested in 41y,� f&, � �C NA`1 (1 �' ✓ ,see Deed Book ige OKi q in the ALA) HAI—Vi/ V' County Registry of Deeds. _an owner by virtue of inheritance. Applicant is an heir to the estate of -obate was in County. _if other interest, such as written contract or lease, explain below or use a separate sheet and attach to this application. fOTIFICATION OF ADJACENT PROPERTY OWNERS: furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given CTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit. (Name) (Address) k) OR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS: acknowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible to osion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems associ- ed with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofang tech- ques. ERMISSION TO ENTER ON LAND: urthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to iter on the aforementioned lands in connection with evaluating information related to this permit application. :ais application includes: general information (this form), a site drawing as described on the back of this application, the vnership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any infor- ation as may be provided orally by the applicant. The details of the application as described by these sources are incorporated :thout reference in any permit which may be issued. Deviation from these details will constitute a violation of any permit. Any :rson developing in an AEC without permit is subject to civil, criminal and administrative action. L i Thi hey� day of , 20 Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application. c� 0 0 z z n turf U) my .t- N 0 m 0 m m a turf turf C$ MILLER DECK SCALE 1" = 4' by NORTH STATE ENS REVISED / 2 / p r R. CAFE, 0 8204 SEP 14 2011 Ivi WILMINGTON, 8200.E ' fi o a 9 / 9-1 0 .1 ,. q� Ai ct j Y M 4 8136 .w, O ale e4 r v A*e 11- 62,'V , CE)VED AUv 3 a 2aff August 26, 2011 Christine Bouffard New Hanover County Inspections 230 Government Center Drive, Suite 110 Wilmington, NC 28403 W Re: 8200 Bald Eagle Lane — Ken Miller y Dear Ms. Bouffard,, Y I am requesting a CAMA permit for 8200 Bald Eagle Lane because we want to add a raised wood deck. Please find the attached plan and "Letters of no objection" from the'adjacent property owners. The need for the deck arose from the need to backfill the bulkhead after making it taller. The taller bulkhead makes it necessary to fill several inches in the area of a large existing live oak tree which would surely kill the tree. Our deck design W includes walls that will retain soil and allow the grade around the oak to stay the Y W same. The deck and walls will also result in a grade that will result in less runoff W° going into the ICWW. Please contact me if you have any questions. My cell number is 910 443-4064 and my email address is matterwin(aD-bellsouth.net. Thank you. ?Qe Matthew B. Erwin North State Gardens, Inc. OUTDOOR LIVING SPACES 910.270.4702 117015 HIGHWAY 17 NORTHSTATEGARDENS.COM HAMPSTEAD, NC 28443 SERVING THE CAROLINAS SINCE 1982 Prr-mvm Ann 1 0 2011 Email Transmission Sandra L. Wornom PO Box 1248 Sanford, NC 27331 Dear Ms. Wornom: 11J I. 0 . e a- . .-• co rq NEE= . e CO IA1— U co �- Postage $ 1.1j0 • J CIO Certified Fee • J Z. C3 p Return Receipt Fee Postmark Here W p (Endorsement RequI e W e, $fJ•Q(1 0 (Rest Endo rseme wired Total Postage & Fees 5 • g 0E/29f ryQi 1 p r o sent , C3 � Street Apt IVo:; or PO Box No. PU Ae0?Q r �- -------------------------------------------------- --------------------------------- City, State, Zr4 /� r d �C e L17-193 I PS Form :W August 2006 See Reverse for instructions This letter is to notify you as an adjacent riparian landowner to 8200 Bald Eagle Lane owned by Mr. Ken Miller of plans to a wooden deck around a Live Oak tree near his bulkhead (see attached drawing). This change requires a modification of the CAMA permit. The need for the deck arose because we do not want to cover the root zone of the oak tree with backfill for the bulkhead. The deck design includes walls that will retain soil away from the tree and allow the grade around the tree to stay the same as it is now. The deck and " walls will also permit a grade that will result in less runoff going into the ICWW. Should you have no objections to this proposal, please check the statement below, sign -and date the blanks below the statement and return this letter to: Matthew Erwin, North State Gardens, Inc., 17015 US Hwy 17, Hampstead, NC 28443 OR email to matterwinna,bellsouth.net as soon as possible. Should you have objections to this proposal, please send your written comments to „ CAMA, Local Permit Officer, New Hanover County Inspections Dept., Zoning Division, 230 Market Place Drive, Suite 110, Wilmington, NC 28403. Comments will be considered up until Y- the time of issuance of the permit. If you have any questions or need more information, please feel free to call me at 910 443-4064. Sincerely, W J , ✓ J Matthew Erwin North State Gardens, Inc. " I have no objection to the project as presently proposed. I have objections to the project as presently proposed and have enclosed comments. " ✓ ✓ " Sianature Date a J• � ✓" OUTDOOR LIVING SPACES 910.270.4702 17015 HIGHWAY 17 SERVING THE CAROLINAS SINCE 1982 NORTHSTATEGARDENS.COM HAMPSTEAD, NC 28443 NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT Pursuant to NCGS I I3A-119(b), New Hanover County, a locality authorized to issue CAMA permits in Areas of Environmental Concern, hereby gives NOTICE that on August 30, 2011: Clifton Benson has applied for a CAMA permit to construct a new driveway at 7 Skimmer Road, Wilmington NC, New Hanover County-. (11-027) Ken Miller applied for a CAMA permit to construct a wood deck with integrated seating at 8200 Baled Eagle Lane, Wilmington NC, New Hanover County. (11-028) The application may be inspected at the address below. Public comments received by September 18, 2011 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. PLEASE PUBLISH ON: Saturday, September 3, 2011 owl Christine lo `�.,{ CAMA Local Permit Officer for New Hanover Count), 230 Government Center Drive Suite 110 Phone: (910) 798-7118 RECEIVED SEP 0 4 2011 r-'M WILMINGTON, NC NW lt-o-�9 AFFIDAVIT OF PUBLICATION STATE OF NORTH CAROLINA COUNTY OF NEW HANOVER -- _M(CATION Before the undersigned, a Notary Public of Said County and State, NOTICE OF FiLfs* Of FOR LAMA MINOR DEVMDPMENT PERMIT Keith Raffone -IA'A 19(tz1,< n I ew uerG; vi CatIty au- thorit ad to issue CIA pErPnits in Areas of Environmental Concern, hereby NOTICE that on Au- Who, being duly sworn or affirmed, according to the law, says that he/she is vves gI st 30, 011 Ken Miller applied for a CAMA. per- mit to construct a wes'detk with Controller inteUrated 5eat�ry at B�S�oNaled Eagta Lane, i+Y;lmi� ton N N w ! of THE STAR -NEWS, a corporation organized and doing business under the Laws of the State of ., , # `I�n6 North Carolina, and publishing a newspaper known as STAR -NEWS in the City of Wilmington rooffca ,�n 04y ba r,isAected at the address below Public corn- mcnts aecen ed by September 18, later NOTICE OF FILING OF APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT ZQ�LY wall he considered comments will be accepted and Pursuant to NCGS 113A-119b, New Hanover County, a locality authorized to issue CAMA eunstderod up to, the tirr,e-ref permit decision 'Project ,Mndificatlons may permits in Areas of Environmental Concern, hereby gives NOTICE that on August 30, 2011: occur based on furthcar review and cornmanU not;;c. of the perrtilt ; - Clifton Benson ha detrYstort 1r: Cl4oSc '�+':?°'• `-� ° for phone (910) 796-7718 was inserted in the aforesaid newspaper in space, and on dates as follows: 913 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 �A' I,UtUltilllglt/y��„ Title: Controller �,% L. O'G,O�,,��ff Sw rn or affirmed to, and s bscribed before me this 44h , d 1 "j , A.D., O ! t pi0iq �L�'' In Testimony Whereof, I have hereunto set my hand and affixed my oicial seal, the day andp year aforesaid. ,r) P/ 1. C G': My commission expires day of , 20_ My COMMISSION EXNRES M 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: v. Clerk of Superior Court RECEIVED SEP 13 2011 DCM W1LMINC_'TnNl ntrr CAMA Minor Permi Log 2011-2012 New Hanover County Oro / Pg. 1 Date Quarterly report received: 10-12-11 1st 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 ae rcv'd Public Notice AEC App Complete Appr. for Payment 11-011 Beane, Agnes 615 Airlie Rd 3/30/11 3/25/11 add info 4/5/11 3/28/11 n/a carry over 11-014 Tank, Edward 234 Windy Hills Dr 4/27/11 4/12/11 add info 5/3/11 4/27/11 n/a N carry over 11-020 Gammage, John 292 Beach Rd N 6/10/11 5/24/11 7/5/11 7/1/11 5/20/11 6/17/11 Y Y Y 11-022 Platt, Claus 1913 Atlantic Dr 7/28/11 7/24/11 8/8/11 8/8/11 7/25/11 7/28/11 n/a Y Y 11-023 Lynn Regnery 7423 Fisherman Crk Rd 8/16/11 8/9/11 8/9/11 9/7/11 8/9/11 8/16/11 n/a Y Y 11-025 Wright, Tim 7 Clamdigger Pt Rd 8/25/11 8/18/11 9/13/11 9/12/11 8/23/11 8/25/11 n/a Y Y 11-026 Cederman, Gary 722 Arjean Dr 9/15/11 8/26/11 9/15/11 9/12/11 8/26/11 9/13/11 n/a Y Y 11-027 Benson, Clifton see 10-027Mod2 9/1/11 8/30/10 x VOID x 9/4/11 n/a x N 11-028 Miller, Ken 8200 Bald Eagle Ln 9/1/11 8/30/11 9/20/11 9/19/11 8/30/11 9/4/11 n/a Y Y 11-029 Hardy, Stuart 6402 Quail Run 9/26/11 9/6/11 9/26/11 n/a carry over 11-030 Bridge Tenders LLC 136 Skystasail Dr 9/26/11 9/21/11 9/26/11 n/a carry over 11-031 Rayburn Jr, Richard 301 Beach Rd N 9/27/11 9/26/11 9/27/11 n/a Y carryover 9-005MOD1 Overton, Parker 13-21 Comber Rd 1014111 1014111 2/5/09 12131108 n/a n/a Y N 10-027MOD1 Benson, Cliff 7 Skimmer Rd 8/17/11 8/15/11 8117111 6110110 5119110 n/a n/a Y N 10-027MOD2 Benson, Cliff 7 Skimmer Rd 9/14/11 9114111 9114111 6110110 5/19/10 n/a n/a Y N filed w/ 4Q 09-10 filed w/ 3Q 08-09 11-007Mod Myerson, Martin 5559 Peden Pt Rd issued 1Q 11/12/11 16 ,_ a 7/27/11 7/26/11 1 1 1 N LOCALITY: NEW HANOVER COUNTY FOR QUARTER.- Jul - SeptYear: 2011 C: C CU (D U E 0 LU IE ? � W CU File # Applicant Name Project Address L Z� U- U- (n .-L - 2: 0 RECEIVED o z 0 E i I D-X 0 .2 0 E .0 6 �2) W M 1-- 0 U. 7@ 2 OCT 13 2011 M .2 .. 0 Ui = (D CL a. 0 Cn %6.- 0 0 4- 0 < 6 - -6 C -C: E 0 W E DCM WILMINGTON, NC 0 CL >, (D X (0 X 0 10-027Mod Clifton Benson 7 Skimmer Road 8/30/11 N/A 3/30/11 6/10/11 ORW 0-driveway 11-007Mod Dr. Martin Meyerson 5559 Peden Point Road 7/26/11 Mod 7/26/11 7/27/11 ES SFR 11-020 M/M John G2mmage, Jr 292 Beach Rd N, Figure 8 Island 6/7/11 617/11 6/19/11 711/11 0 SFR-addition 0-retaining 11-022 Claus & Faith Pratt 1913 Atlantic Drive 7/22/11 7/27/11 I 7/28/11 8/8/11 ES wall 11-023 Lynn Regnery 7463 Fisherman Creek Dr 8/15111 8118/1118/15/11 9/7/11 ORW 0- garage 11-024 M/M Jim Sweetwood 6404 Timber Creek Lane worked as an Exemption # Et 1 -0 10 0- drive, walkway, 11-025 Tim & Carol Wright 7 Clamcligger Point Rd., Figure 8 8123/11 8/26/11 8/30/11 9/12/11 ES wall 11-026 M/M Gary Cederman 722 Arjean Drive 8/26/11 8131/11 8/30/111 9/12/11 1 ES SFR 11-027 Clifton Benson 7 Skimmer Road worked as 2nd Modification # 10-027 11-028 Ken Miller 8200 Bald Eagle Lane 8/30/11 9/3/11 8/30/11 9/19/11 ORW 0- deck carried 11-029 M/M Stuart Hardy 6402 Quail Run 9/22/11 9/24/11 9/26/11 fwd ORW SFR, pool carried 11-030 Bridge Tenders, LLC 136 Skystasail Drive 19/22/11 9/24/1119/26/111 fwd- I ES SFR I a LP,O COMPOSITE RECORD FORM FOR MINOR PERMITS LOCALITY: NEW HANOVER COUNTY FOR QUARTER: Jul - Sep 1 Year: 2011 .� E o 6. m a� wcn > a cn in — E 2 w File # Applicant Name Project Address C � y �'' L) 2 CO N N M L d O _ C O l d E O Z Q N _ p O m(n o LL 0 a tU 0 w x o c- a' in ai 0 0 0 0 a o f M M M M n� a o U 0 0 o F�=U) H�U 10-027Mod Clifton Benson 7 Skimmer Road 8/30/11 N/A 3/30/11 6/10/11 ORW 0-driveway 11-007Mod Dr. Martin Meyerson 5559 Peden Point Road 7/26/11 Mod 7/26/11 7/27/11 ES SFR 11-020 M/M John Gammage, Jr 292 Beach Rd N, Figure 8 Island 6/7/11 6/7/11 6/19/11 7/1/11 O SFR-addition 0-retaining 11-022 Claus & Faith Pratt 1913 Atlantic Drive 7/22/11 7/27/11 7/28111 8/8/11 ES wall 11-023 Lynn Regnery 7463 Fisherman Creek Dr 8/15/11 8/18/11 8/15/11 9/7/11 ORW O- garage 11-024 M/M Jim Sweetwood 6404 Timber Creek Lane worked as an Exemption # Ell -010 O- drive, walkway, 11-025 Tim & Carol Wright 7 Clamdigger Point Rd., Figure 8 8/23/11 8/26/11 8/30/11 9/12/11 ES wall r � F 11-026 M/M Gary Cederman 722 Arjean Drive 8/26/11 8/31 /11 8/30/11 ES SFR 11-027 Clifton Benson 7 Skimmer Road worked as 2nd Modification # 10-027 carried 11-028 Ken Miller 8200 Bald Eagle Lane 8130/11 9/3/11 8/30/11 fwd ORW O- deck OU 13 carried 11-029 M/M Stuart Hardy 6402 Quail Run 9/22/11 9/24/11 9/26/11 fwd ORW SFR, pool carried 11-030 Bridge Tenders, LLC 1136 Skystasail Drive -M WILMINICn 9/22/11 9/24/11 9/26/11 fwd I ES I SFR CO C C C M C O 7 U)= _O O m W U) � O LU M L U- U- `m File # Applicant Name Project Address .� 2.- O + N N N ED M r M L d O 0 d O = £ ' Zc c O O U N = F- a. d N i >y a n. cn Q a 0 0 0 0 o f r ram+ -w ��. C. N O CL fA O U carried O- addition, 11-031 Richard Rayburn, Jr. 301 Beach Road North, Figure 8 9121111 9130/11 10/3/11 fwd ORW deck, septic Return To: Division of Coastal Management 127 Cardinal Drive Extension Wilmington, NC 28405 Signature: A, Date: October 12, 2011 Phone Number : 798-7118 OCT 13 2011 DCM, WiLMINOTON, INC _S_ .. _. _ ........_ .. . Local Government: Period Covered: FY: 2011-2012 Services Rendered: REQUISTION FOR PAYMENT OF CAMA MINOR PERMIT PROGRAM IMPLEMENTATION AND ENFORCEMENT dcl&j 4,4ro%x. e611Wry X lst Quarter (July -Aug -'Sept) 2nd Quarter (Oct - Nov - Dec) 3rd Quarter (Jan - Feb - Mar) 4' Quarter (Apr - May - Jun) OH_ .ES = Permits processed @ $55.00 each $ (Cities and towns) OH /. ES 5 = b . Permits processed @ $75.00 each $ 0 • (Counties) OH ESFinal"Inspections @ $40.00 each OH d- 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 The above information is an accurate account of activities carried out by the local government staff during the period specified above. I approve for pay ent. DCM Regional a resentative Date: / / — /C. — / / DATE RCVD IN WILMINGTON OFFICE: DATE SENT TO MOREHEAD CITY OFFICE: DATE PAID: