OI 11-20

Oak Island 0111-20
Local Government Permit Number
CAMA
•' 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 Phil Williams, authorizing development in the Ocean Hazard (AEC) at 5212 E. Beach Dr., in Oak Island, as
requested in the permittee's application, dated 6/10/11. This permit, issued on 7/1/2011, 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, the placement of a 300 sq. foot open ground level deck.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 6/10/2011.
(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 [phone] for a final inspection at
completion of work.
(Additional Permit Conditions on Page 2)
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:
July 2, 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.
Donna F. Coleman
LAMA LOCAL PERMIT OFFICIAL
4601 E. Oak Island Dr.
Oak Island, NC 28465
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Phil Williams
Minor Permit # 0111-20
Date*701/2011
Page 2
--
(5) The structure must set back a minimum of 60 feet from the first line of stable natural vegetation, as determined y W the DCM, the LPG, or other assigned agent of 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 1 00-year flood level elevation.
(9) All pilings shall have a tip penetration greater than eight feet below the lowest ground elevation under the structure,
(10)Dune disturbances will be allowed only to the extent necessary for development and if the dune's protective value is
not weakened or reduced. Disturbed dune areas will be immediately stabilized.
(1 I)AII 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.
(1 2)Any structure authorized by this pen -nit 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 renouhshment 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 rebGated 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.
r-7- i V E
DrIm
U L
SIGNATURE:
PERMITTEE
DATE:

Locality -� `' Istar Permit Number
Ocean Hazard Estuarine Shoreline ORW Shoreline blic T ShoreMK
line
(For official use only
GENERAL INFORMATION
LAND OWNER
Name ' '
Address
p ' �' ;� ,, : "Phone
City �,.__�t , �- f-,t A:State ,`,= � ;> � Zi
t
Email
AUTHORIZED AGENT
Name
Address
City
Email
State Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
yM..
adjacent waterbody.) J Z � 5 t .>
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
SIZE OF I,OTIPARCEL: `ice square feet "'I �� acres
PROPOSED USE: Residential } (Single-family EI Multi -family E ] ) Commercial/Industrial n Other []
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your proper(y):
(I) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: I 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: xr .A 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
If yes, list the total built upon area impervious surface allowed for your lot or parcel: ,4e feet.
AIL .15 2011
"ki NC

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, Hearing 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 CAMAminor 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)
�`� ,.3b
an owner or record title, Title is vested in is Ft' -i e- I. } � see Deed Book
page p� Ste in the '�: County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
i 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.
(Name) (Address)
(3) 1. c j -i c 1 >m t r �'" c` �' �i i L .410 ;z_•r t(
r h
ACKNOWLEDGEMENTS:
I, 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. I 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 concerning stabiliza-
tion and floodproofing techniques.
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 pe it application.
This the�;�
day of _ , 20_'
Landowner or person authori ' d 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 Hazard AEC Notice where necessary, a check for $100.00 made payable to the locality, ani
any information as may be provided orally by the applicant. The details of the application as described by these sources art
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation a
any permit. Any person developing in an AEC without permit is subject to civil, criminal and agin'i 7ipn.
.n
JUL 15 2011
"'' \P.It. G47 hI P - . ,

AEC HAZARD NOTICE
Project Is In An: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner: l11V
Property Address: />
Date Lot Was Platted:/,�� JLc
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 - � feet per year.
The rate was established by careful analysis of aerial photographs
of the coastline taken over the past 50 years.
Studies also indicate that the shoreline could move as much as
3 Z S feet landward in a major storm.
T e ood 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 signifig)tys notice in the space be19w. Without the proper
signature,
not be coffrolete.
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 ofthe
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 remeasured. Also, the occurrence of a major
shoreline change as the result of a storm within the 60-day period
will necessitate remeasurement 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 information, contact:
(Dd)-)r-1 d-ti rl- /,C in.1V?
Local Permit Officer
/ l
�01' (, n'it- �5tf�a7
Address
.zs Z
Locality
9
Phone Number
9.�oi!l
RECEIVED
JUL 15 2011
WILMINGTON, NC
Agplicant
Revised 2107

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(Staple Here)
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Adjacent Pro e Owners S %�C {� 2 {�On� G v'4 / �`
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City, State, Zip Code
Dear Adjacent Property:
have applied for a CAMA Minor
This letter is to inform you that I,
Property Owner
Permit on my property at e l Z in Oak Island.
Property Address
As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawings} 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 _,/ �' I1 - , 2-3 f or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to:
Donna F. Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincer y, 1 7009
roperty Own
Mailin ress i
t/7x eleq
City, State, Zip Code 7-7 Z
RECEIVED it
JUL 15 2011 �.
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DCM WILMINGTON, N ,
28PO 0001 0979 8433
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Dear Adjacent Property: or
This letter is to inform you that I, LIq have applied for a CAMA Minor
Property Owner j
Permit on my property at y V- r✓ � i "��� in Oak Island.
Property Address
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 q��—�6 0 �3� or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the Town of Oak Island CAMA Minor Permit Program, you may submit
them to: RECEIVED
Donna F. Coleman
Local Permit Officer for the Town of Oak Island JUL 1 5 2011
4601 E. Oak Island Dr.
-�, Oak Island, NC 28465
P perty Owner
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City, State, Zip Code
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Postage $
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NOTICE OF FILING OF APPLICATION
FOR CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS 113-A-119(b), Town of Oak Island, a locality authorized to issue CAMA permits, hereby
gives NOTICE that the following applications for CAMA Minor Development Permit(s) have been received:
The applications may be inspected at the address below. Later comments will be accepted and considered up to
time of permit decision. Notice of the permit decision in this matter will be provided upon written request.
Number
Name
Address
Development
OI 11-19
Dr. Arnold Smith
803 Ocean Dr.
deck, clay walkways
OI 11-20
Phil Williams
5212 E. Beach Dr.
Wooden Deck
OI 11-21
Shaun Wilcox
3102 E. Yacht Dr.
Single Family Residence
Donna Coleman
CAMA Local Permit Officer
Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Phone: [phone]
PLEASE PUBLISH ON: June 15, 2011
Billing information for this ad:
Becky Beard
Town of Oak Island
4601 E. Oak Island Drive
Oak Island, NC 28465
Comments through
July 1, 2011
July 1, 2011
July 1, 2011
RECEIVED
DCM WILMINGTON, NC
JUL 1 5 2ii'l

CAMA Minor Permi
Log 2011-2012
Oak Island
Wiro / Pg. 1
Date Quarterly report received: 10-18-11
1 st Quarter
Permit
No.
Applicant's 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
11-20
Williams, Phil
5212 E Beach Dr
7/15/11
6/9/11
7/15/11
7/1/11
6/10/11
7/15/11
Y
Y
Y
11-21
Wilcox, Shaun
3102 E Yacht Dr
10/25/11
6/13/11
10/18/11
7/11/11
6/13/11
10/18/11
n/a
Y
Y
11-22
Holland,, Lawrence
7602 E Beach Dr
7/15/11
6/25111
7/15/11
7/11/11
6/27/11
7/15/11
Y
Y
Y
11-23
Crisco, Charlie
3526 E Beach Dr
7/15/11
6/29/11
7/15/11
7/22/11
6/29/11
7/15/11
Y
Y
Y
11-24
Lawrence, Kent
3015 W Beach Dr
7/20/11
7/11/11
9/9/11
8/5/11
7/14/11
7/20/11
Y
Y
Y
11-25
Pharma Phams LLC
6624 W Beach Dr
8/5/11
7/29/11
8/5/11
8/19/11
7/29/11
8/5/11
Y
Y
Y
11-26
Rickman, David
123 SW 12th St
9/23/11
8/8/11
9/23/11
9/2/11
8/10/11
9/23/11
n/a
Y
Y
11-27
Williams, Derek
127 SW 5th St
9/23/11
8/15/11
9/23/11
9/9/11
8/19/11
9/23/11
n/a
Y
Y
11-28
Grimes, Annie
5223 E Pelican Dr
9/23/11
8/18/11
9/23/11
9/9/11
8/19/11
9/23/11
Y
Y
Y
. 11-29
Keesee, Brian
622 E Beach Dr
9/23/11
8/25/11
9/23/11
9/16/11
8/25/11
9/23/11
Y
Y
Y
11-30
Cordell, Ann
906 Elizabeth Dr
9/23/11
8/23/11
9/23/11
9/9/11
8/25/11
9/23/11
n/a
Y
Y
11-31
Sweet, Sara Ann
1004 W Pelican Dr
10/25/11
9/9/11
10/18/11
9/30/11
9/9/11
10/18/11
n/a
Y
Y
11-32
Luciano, Jack
1504 E Yacht Dr
10/25/11
9/12/11
10/18/11
9/21/11
9/12/11
10/18/11
Y
Y
Y

LPO COMPOSITE RECORD FORM FOR MINOR PERMITS
LOCA PTY:�.QAK I.SLAN.P....
FOR QUARTER :i
—
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Year.
2011-2�12
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File #
Applicant Name
Project Address
UJ
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0111-20
Phil Williams 5212 E. Beach Dr.
-Shaun
06/110/11
16/15/2011
06t13111
07/01/11
L
30,H
SFR
0111-21
Wilcox
..................... . .
3102 E. Yacht Dr.
06/13111
06127/11
6115/2011
6/2912011
06108111
06(29111
4 .....
:07111111
107/11/11
........... ........... . . . .........
ES
10E
SFR
SFR
SFR
0111-22
Lawrence Holland 7602 E. Beach Dr.
0111-23
Traci & Charlie Crisco
13526 E. Beach Dr.
6&/M6/201 1
oil
7/W01 1
7/18/2011
7/2=011
0,H
SFR
0111-24
K
Kent & Shannon Lawrence
13015 W. Beach Dr.
7/14/2011
7/20/2011
7/20/2011
815=11
QH
SFR
0111-25
Pharma Phams, LLC 6624 K Beach Dr.
07/29111 18/312011
. . . . ... . .......
07/28/11
108119/11
1,H
SFR
011126
!David & Holly Rickman 123 SW 12th St
W10111
8/17/2011
08/15/11
�09/02/11
SFR
0111-27 IDerek
.... . ...................... .... . .......... . .. . . .
Williams
127 SW Sth St
08/18/11
8/24/2011
08117/11
:09/09/11
09/09/11 10,H
ES
SFR
SFR
011128
Annie Grimes 15223
Keesee .622
E. Pelican Dr.
........... ........... . — . . . . ..... . ..
E. Beach Dr.
M19/11 18/24t2011
......... . ................... . .
08125/11 18/31/2011
08/31/11
08/31/11
08/31/11
011129 113han
09/16/11 jO,H
SFR
0111-30 !'Ann
. ...... . ........
Cordell . .......
906 Elizabeth Dr.
. ......
08/26/11
;09109/11 1ES
SFR
0111-31 'Sara
f
Ann Sweet
. . . . . . ....... ........ . ..........
1004 W. Pelican Dr.
. . ........ 1-111 .....
09/09/11
. ......
9/14=11
09/ 14/11
09/30/11 IES
SFR
0111-32
- ............ -
Jack Luciano
. ...... ----------- -----
3216 E. Pelican Dr. R E Q E I V E 0
��t 11
. . . . ...................................
. ...... . .
9/14/2011 .09/14/11
.... . ..........
09/21/11
0,H
SFR
Division of Coastal Management DCM WILMINGTON, lJC
7
Return To:
S, nature:
. ........
,44-
. . . . .......
............
127 Cardinal Drive Ext. I OCT 19 2011
. . ................. .
Wilmington, NC 28405-3845
Ll 910:201-8047
Phone Number:

L-f-V %oVMrUZJ1 I t KtUUKU 1-UKM I�UK EXEMPTIONS
. . ... . ....... . ... . .....
LOCALITY- oak Island
FOR QUARTER: 1 sT
Year:
. . ........ .
2011-2012
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M&R 11-37
Carolyn Hicks
205 Sherrill St
7/5/2011
7/1/2011
7/5/2 011
0, H IRM
SFR
M&R 11-38
NC Beachouse LLC
926 E. Beach Dr.
7118/11
7/15111
7i1812011
O,H
RM
SFR
M&R 11-39 Helen Ledford
. .........
906 E. Beach Dr.
. . ........ ................... :07/25/11
07/25/11
07/25/11
0,H
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SFR
M&R 11-40 .James Simpson.1318
. . ...... . ......................
W. Beach Or,
08102/11
......... . ....................... .............
08102/11
08/02/11
RM
SFR
M&R 11-41 Bryan& Phyllis Soltz
...... . ........ . .
1724 W. Pelican D
r. . . ........ . . . . . .................
08/08/11
08t08111
08/08/11
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...
RM
SFR
M&R 11 -42 Rebecca Young
............
616 E. Pelican Dr.
. ..... . 08/11/11
08/11/11
08111/11
0,H
. .......
RM
SFR
M&R .11-43 Sherry Kent
1308 W. Beaqch Dr.
. . . .......
102/12/11
08/12/11 :08/
12/11 10,H
RM
SFR
M&R 11-44 Elizabeth Wood
... ............... ___ ........................... . . .......
5004 E. Yacht Dr.
:08/15/11
08115/11
08115/11
ES
RM
SFR
M&R 11-45 Pat Wells . ......
5714 W. Beach Dr.
08/16/1 1
08/16/11
0,H
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SFR
M&R 11 -46 Sidney Thames ............ .
........ . Beach Dr.
......................... 08/17/11
0,H
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SFR
M&R 11-47 Tom Griffin ...................
toWL779W).
1571 W. Beach Dr.
08/17/11 08117/11
08/17/11
0,H
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SFR
M&R 11 -48 Terry Tucker
W. Beach Dr.
09/13/11 09/13111 09/13111
0,H
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SFR
Return To: Division of Coastal Ma
apapment
R E C E I'V��E 0( - ____
— ­ --- --
Signature:
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1-1
127 Cardinal Dr. Ext.
Date:
10/7/2011
41"tT, - - - ­--
Wilmington, NC 28405-3845
Phone Nurnber:
910 201-8047

LrU i t Kt=k UKU t-UK HNAL 51 1 t INSPh(;-iIONS
LOCALITY OAK ISLAND FOR QUARTER: 1ST
YEAR: 2011-2012
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Applicant Name
Project Address
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OI 10-40
Leon Capel
216 SW 15th St
storage
7/7/2011
ES
OI 10-41
Dan Anderson
2016 W. Beach Dr,
SFR
7/14/2011
O,H
OI 10-47
Leo Anderson
2928 E. Beach Dr.
SFR
8/10/2011
O,H
OI 11-03
Jeff Agee
2920 E. Pelican Dr.
deck
7/20/2011
ES
OI 11-04
Peter Soward
2508 E. Dolphin Dr.
addition
7/21/2011
O.H
OI 11-05
Malcom Mayer
226 W. Beach Dr.
pool,deck
7/21/2011
O,H
OI 11-11
Robert Yingling
610 E. Beach Dr.
addition
7/20/2011
O,H
RECEIVED
OCT1
Return To: Division of Coastal Management
127 Cardinal Dr. Ext.
Wilmington, NC 28405
Signature:�,
Date: 10/13/2011
Telephone: -910 201-8047

REQUISTION FOR PAYMENT
OF CAMA MINOR PERMIT PROGRAM
IMPLEMENTATION AND ENFORCEMENT
Local Government: 0'9- 1�510vfy_>
Period Covered: X I" Quarter (July - Aug - Sept)
FY: 2011-2012 2nd Quarter (Oct - Nov - Dec)
3`d Quarter (Jan - Feb - Mar)
41h Quarter (Apr - May - Jun)
Services Rendered:
OH $ ES L) = 13 Permits processed @ $55.00 each
(Cities and towns)
OH ES = Permits processed @ $75.00 each
(Counties)
OH 0 ES Final Inspections @ $40.00 each
OH // ES / _ /c�-- 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
ii!
The above information is an accurate account of activities carried out by the local government
staff during the period specified above. I approve for payme .
DCM Region Repres tative
Date: /0 —/ - / /
DATE RCVD IN WILMINGTON OFFICE: /0 —0 —//
DATE SENT TO MOREHEAD CITY OFFICE:
DATE PAID: