OI 11-30-CORDELL

Oak island
Local Goverriment
0111-30
Permit Number
Wml
MINOR DEVELOPMENT
124
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 W Section 113A U 4; of the
General Statutes, "Coastal Area Management"
Issued to Ann Cordell, authorizing development in the Estuarine Shoreline (AEC) at 906 Elizabeth Dr., in Oak Island, as
requested in the permittee's application, dated 812512011. This permit, issued on 9/0912011, is subject to compliance
with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions
and notes sell 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 auftrizes: An enclosed deck addition with associated development.
11)
All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 8125/2011.
(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 change,, in the plans for development, consInxtion, 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. CAmOct this office at (910 278-5024 for a final inspection at
completion of wok RECEIVED
(Additional Permit Conditions on Pop 2) DCM WILMINGTON, NC
SEP 2 6 2011
This permit action may be appealed by the permittee or other qualified persons
within twenty (20) days of it* 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 or, the project site and accessible to the permit officer when the
project is inspected for compliance, Any maintenance work or project
modficatior; not covered under this permit, require further written permit
approval.Allwork must cease when this permit expires on:
April 23, 20111
in issuing this permit it is agreed that this project is consistent with the kcal Land
Use Plan and all applicallo ordinances. This permit may not be transferred to
another party without the written approvai of the Division of Coastal.
Management
NY\Ci 4-
Donna F. Coleman
LAMA LOCAL PERMIT OFFICIAL
Town of Oak Island
PERMITTEE
(Signature required if wnditk)ns above apply to permit)

Name: Ann Cordell
I=
(5) The amount of impervious surface shaP not exceed 30% of the lot area within 75 feet of the Norman high water
(Estuarine Shoreline Area of Environmental Concern), in this case, 2404 square feet is authorized.
(6) Unless specifically allowed in 15A NCAC 07K 0209(d)(10), and shown on the permitted plan drawing, all
developmentf,construction shag be located a distance of 30 feet landward of the 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 fitter cloth must
be installed between the land disturbing activity and the adjacent marsh or water areas, until such time as the area
has been prolmirly 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.
SIGNATURE: DATE:
J PERMiTTEE
RECEIVED
DCM WILMINGTON, NC
SEP 2 6 2011

Locality '-ACN t I Pen -nit Number of W 3C
Ocean Hazard — Estuarine Shoreline ORW Shoreline — Public Trust Shoreline— Other
(For (fficial use Only
GENERAL INRMA:r[QN
LAND OWNER
Name
Address 0 6- C'__
City nk, /1441-7d State
Zip _'2 k q b,5­ phone � 7W 4 1.4 3 p I - 1§11
AUTHORIZED AGENT
Name 1,42-s n'�J
Address L 0 6 gzL 6 e H-3
City -Lale- _k51q,,,d State fl C.- Zip W � &� Phone <7 / 6-1 a? S / a 3 5— —
LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) 0 ') e-
-2,n lie
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
_J( 0 V
SIZE OFLOT/PARCEL* square feet i acres
PROPOSED USE: Residential ----.ems (Single-family -'­ Multi -family Commercial/Industrial
Other
TOTAL ENCLOSED` FLOOR AREA OF A BUILDING IN THE OCEAN HA7,ARD AREA OF ENVIRON-
MENTAL CONCERN (AEC): ____ - square feet (includes all floors and roof covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT UPON SURFACES IN THE
COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): I rlHt4_ _ _ square feet
(Calculations includes the area of the rooP4rip line of all buildings, driveways, covered decks, concrete or masonry patios,
etc., that are within the applicable AEC. Attach your calculations with the prQject drawing.)
Choose the AEC area that applies to your property:
/(I) within 75 feet of Normal High Water/Normal Water Level for the Estuarine Shoreline AEC
(2) within 575 feet of Normal High Water/ Normal Water Level for the Estuarine Shoreline AEC, adjacent to
Outstancbrig Resource Waters
(3) within 30 feet of'Normal High Water/ Normal Water Level for the Public Trust ShorelineC
' AE
{Contact your Local Permit Officer if you are not sure which AEC applies to your property-)
STATE STORMWATER MANAGEMENT PERMIT- Is the project located in an ar nsletfv�±b Stormwater
Management Permit issued by the, NC Division of Water Quality? DCM WILMINGTON, NC
YES NO "
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: S E P 2 _6 _2011quare feet

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor develop-
ment permit. As a service we have compiled a listing of the kinds of permits that might be required. We suggest you check over the list
with your LPO to determine if any of these apply to your project, Zoning, Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, I {eating and Air Conditioning, Insulation and Energy Conservation, FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, highway Connection, and others.
STATEMENT OF OWNERSHIP:
1, the undersigned, an applicant for a LAMA 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 fora 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)
_]_an owner or record title, Title is vested inALIVII see Deed Book 014.5—
page Z5yv'7 in the &rL)n S 4,12 ie-'k County Registry of Deeds.
an owner by virtue of inberitance-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 CAM A pert -nit.
(Name) (Address)
�4 6
FOR DEVELOPERS IN OCEAN HAZARD AND .ESTUARINE HAZARD AREAS:
I 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 particular hazard problems
associated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing
techniques,
PERMISSION TO ENTER ON LAND-
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to
enter on the aforementioned lands in connection with evaluating information related to this permit application.
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the AEC haza'rd notice where necessary, a check for $100.00 made payable 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 permit. Any person developing in an AFC without permit is subject to civil, criminal and administrative action.
RECEIVED
DCM WILMINGTON, NC This the -;23 day of
SEP 2 6 .2011
Landowner or person authorized to act as his agent for purpose of filing a LAMA permit application,

STATE OF NORTH CAROL INA
BRUNSWICK COUNTY
ROBERT B. NC HENRY, SR CERTIFY
THAT T H 1 9 MAP WAS DRAWN JNDER MY
SUPERVISION FROM AN ACTUAL FIELD
SURVEY MADE UNDER MY SUPERV13ION:
THAT THE RATIO OF PRECISION AS
CALCULATED BY LATITUDE AND BE-
PARTURE9 19 I 1 IDMI! THAI THE
S OUNDAR IES NOT SURVEYED ARE SHOWN
AS BROKEN LINES PLOTTED FROM ��N-
FORMITION FOUND IN BOOKS REFER-
ENCED: THAT THIS MAP WAS PREPARED
IN ACCORDANCE WITH G.S. 4)-30 AS
AMENDED.
W N SS NY HAND AND SE THIS THE
DAY OF_&OVE_MMAD 1089
LAND SURVEYOR, REGIS NO. L-039
�a CAROB
z SEAL v
p L 839 0
ms
U v
qT a M4�
.1�
NOTE: PROPERTY IS IN FLOOD HAZARD
ROB£RT B. mcH£NRY, SR
REGISTERED LAND SURUEYOR
P. D. BOX 433
105 S. E. 46 th STREET
LONG BEACH, N. C. 28461
TEL : [phone]
ELIZABETH RIVER
7t� HIOH WATER MARK
Y�C
r
TE P iE iP
ZONE Al2 BASE ELEVATION 12 FT
REF: FEMA FLOOD INS RATE MAP
COMMUNITY NUMBER 370030 PANEL
NUMBER 0002 SUFFIX C 12/85
1
3
ai
O
-
0
LEGEND:
NIP - NEW IRON PIPE SET N
EIP - EXISTING IRON PIPE FOUND M
ECM - EXISTING CONCRETE MONUMENT »
PP - POWER POLE
OPC - OVERHEAD POWER CABLE
TBM = TEMPORARY BENCHMARK Z
STATE OF NORTH CAROLINA
S RUNSWI CK COUNTY
I. A NOTARY PUBLIC OF THE COUNTY
AND STATE AFORESAID, CERTIFY THAT
ROSERT B. McHENRY, SR, A REGIS-
TERED LAND BUPVE YOR P£PSONAL.LY
APPEARED BEFORE M£ THIS DAY ANO
ACKNOWLEOOED THE EXECUTION Of THE
FOREGOING NE' INSTRUWRNT. WITNESS MY
PP
H ANO AND OFFICIAL 5TAOR SEAL
TM s DAY OF
A D 'SBB
0
AVERAGE GROUND X
ELEV 17.8 FT N,
25. 5'
12'
B'
r
n
w
O
in
a
STORY N o
FRAME M
N
M
ELEV
n
19. 86 FT
-
Tit- N
N
-
UI)
25. B'
1
R1
cep
70. 00'
+— S 84° 28' 00" W
BLOCK lAAR
YAUPON
VILLAGE
YAUPON BEACH
E IP
194.92 FT ALONG R/1V
TO BARBEE BLVD -------
NOTARY PU9LlC ----
1dY COMM13910N EXPIRES:
RECEIVED
DCM WILMINGTON, NC
E ELIZABETH DRIVE 60 FT R/W
--------------------SEp---�011

t
x
RECEIVE
DCM WILMINGTON NC �

7045877067 BARI OWORI_1) BARI OW WORLD 01 -59:40 p.m. 06-24-2011
ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CA.MA MINOR PERMITS
l herebycertify that 1 7
Y vwn property adjacent to - �
%' (Nan" of Property Owner) /
property located at f`) f �i�.z-&f�_1-�
Address, Lot, Block, Road, *to.)
on �(- t" in e-
(Watarbody) N.C.
(Town and/or Cou Y}
He has described to me as shown in the attached application and proSeCt drawing(s), the
d6'rr 10PrPent he is proposing at that location, and, I have no objections to his proposal,
PPLICAT
OF PROPOSED DEVELOPMENT ATTAC
turd
Print or Type Name
"t s o -`I 22_ 1-S$
Telephone Number
g
Date
RECEIVED
DCM WILMINGTON, NC
SEP 2 6 2011
A
1001E 2nli48 v NI 399v5S3A ZLTT8LZ016 XiV BT:ET TT0Z/DZ/80
ZLTT8LZMT6

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 41V A/ 0.0
(Name of Property Owner)
property located at
Address, Lot, Bock, Road, etc.)
on l ' I cu , in 00 1,/ % 5 JC4 n C/ N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the
development he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
07
SignaWe 1
L31-il y 1y1 o x /!Y
Print or Type Name
67& - 1q.3 46G %
Telephone Number
Date
RECEIVED
DCM WILMINCITON. NC
SEP 9. 6 ' . I

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 11-29
Brian Keesee
622 E. Beach Dr.
single family residence
OI 11-30
Ann Cordell
906 Elizabeth Dr.
covered porch addition
Donna Coleman
CAMA Local Permit Officer
Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Phone: [phone]
PLEASE PUBLISH ON: August 31, 2011
Billing information for this ad:
Cathy Robbins
Town of Oak Island
4601 E. Oak Island Drive
Oak Island, NC 28465
Comments through
September 14, 2011
September 14, 2011
RECEIVED
DCM WILMINGTON, NC
SEP 2 6 2011

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 KU
rcv'd
Public
Notice
AEC
App
Complete
Appr. for
Payment
11-20
Williams, Phil
5212 E Beach Dr
7/15111
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
6/25/11
7/15/11
7111/11
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
7/15111
Y
Y
Y
11-24
Lawrence, Kent
3015 W Beach Dr
7/20/11
7/11111
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
818/11
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
9123/11
8/23/11
9/23/11
9/9/11
8/25111
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
1.1-32
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
---.
_
_ .. ____--
LOCALITY OAK ISLAND
FOR QUARTER
_.._.__._
1ST
Year,
20�11-2012
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File #
Applicant Name
Project Address
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16/15/2011106/13/11
01 11-20
Phil Williams 5212 E. Beach Dr.
_—..............................
Shaun Wilcox 3102 E. Yacht Dr.
_..._ - .._..... _
Lawrence__.Holland 7602 E. Beach Dr.
06/10/11
07/01111
0,11
SFR
Cif 11-21
06/13/11
6116/2011,t>6/08111
` &29/11
07/11J11
ES
SFR
—
SFR
01 11-22
06/27/11
6/29/2011
07/11/11
CE
01 11-23
Traci & Charlie Crisco
3526 E. Beach Dr.
8/262011
7/6/2011
7/18/2011
7/22/2011
0,H
SFR
01 11-24
bent & Shannon Lawrence
3015 W. Beach Dr,
7/14/2011
71=011
17`120t201 1
8l5/2011
O,H
SFR
01 11-25
Oi 11-26
Pharma Phams,LLC
David & Harr Rickman
6624 W. Beach Dr.
123 SW 12th St �W`10111
07/29/11
8/3/2011
8/1712011
'07/28/11 '08/19/11
08/15/11
:I,H
09/02/11
ES
SFR
SFR
01 11-27
Derek Williams
127 SW 5th St
08/18/11
8/24/2011
08117/11
09/09/11
ES
SFR
01 11-28
_.
:Annie Grimes _
5223 E. Pelican Dr.
...__.._.................. --.......... ...-- _
08/19/11
8/24/2011
_
08/31./11
09/09/11 10,H
SFR
Brian Keesee
-- —
. ... -.
622 E. Beach Dr. 1OW5111
_..._........._........--_.......---.........._..........
-
.—..
08/31/11
09/16/11 `O,H
SFR
01 11-29
8/31/2011
01 11-30 —--.
Ann Cordell _._..�.m._o..........
906 Elizabeth Dr.
08/26/11
W1/2011
_ —
08/31/11 109/09/11
—
ES
SFR
01 11.31
Sara Ann Sweet
—--_._..__
1004 W. Pelican Dr.
...............
09/09/11
_._..._._
9/14/2011
09/14/11
09/30/11 �
ES
SFR
3216 E. Pelican Dr. tR E C E I V E
_
912111
9/14/2011
09114/11
09/21/11
O,H
SFR
0111-32
--
Jack Luciano
- - -----
Retum To
Division of Coastal Management DCM WILMINGTON,
------ ....
C
..... ................
................. _
Signature:
-- --_
—
-- — -
127 Cardinal Drive Ext. 1OCT 1 2011
Date: `
10/7/201
_ ..........
Wilmington, NC 28405-3845
Phone Number:
910i201-8047
_._....______..... .
.........

L-r'W %o%JMr%JQI I C Kr-LoUKU 1-UKM 1-UK hAhMPTIONS
. ................
. ..... . LOCALITY: Oak island
FOR QUARTER:
Year:
2011-2012
1ST
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M&R 11-37
Carolyn Hicks
205 Sherrill St
7/5/2011
711/2011
7/5/2011
O,H IRM
SFR
M&R 11-38
NC Beachouse LLC
926 E. Beach Dr.
7/1 a/1 1
7/15111
7,18/2011
O,H IRM
SFR
..........
M&R 11-39 Helen Ledford
906 E- Beach Dr.
... . . .... . 07125111
07/25/11
07/25/11
0,H
RM
SFR
M&R 11-40 James Simpson .. . . . .......
1318 W. Beach Dr,
08/021 11 08102111
08/02/11 10,14
RM
SFR
M&R 11 -4 1, Bryan& Phyllis Soltz
1724 W. Pelican Dr.
08/08/11
08/08/11
08/08/11/11
RM
SFR
MR 11-421Rebecca Young,
616 E. Pelican Dr.
. .. . . . ..............
08/11/11
08/11/11 108/11/11
O,H
RM
SFR
M&R 11 -43 Sherry . Kent ..
. ...................... .
1308 W. Beaqch Dr.
. ............... .....
10 1
08/12/11
.................. . 10,H
AM
SFR
M&R 11-44 Elizabeth Wood
...................... . .. . ........ . .... . .. . .............
5004 E. Yacht Dr.
............... ...... . .. ....
. .....
08/15111 '08115/11
ES RM
SFR
M&R 11 -45: Pat Wells
.................. -- --
5714 W. Beach Dr.
08/1 6M 1 ;08/16/11
:08/16/11 1 0,H
RM
L
SFR
M&R 11 -461 Sidney Thames 507 W. Beach Dr.
.
......... . . ............... 08/17/11
....... . ... . ....
08/17/11 :08117/11 10, H
..........
RM
SFR
M&R 11-47 Tom Griffin 5719 W. Beach Dr.
...... ......
08/1 7/11 08/17/11 08/17/11 0,H
RM
SFR
M&R 11-48 Terry Tucker 3909 W. Beach Dr.
. . . . ....................
09/13111 09/13/11 09/13/11 O,H
-RECEIV�Eo
RM
SFR
Return To Division of Coastal Management Signature: . . . ....... ... . ......
127 Cardinal Dr. Ext.
Date: 10/7/2011
----
I 42U1T-7-­­
1� ­'
Wilmington, NC 28405-3845
Phone Number.-
910 201-8047

LrU k_,UIVIrUai I t KtI.VKU t-UK HNAL SI 1 t INSNt(; IIUNS
LOCALITY OAK ISLAND FOR QUARTER: 1ST
YEAR: 2011-2012
'a
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M Co .0
T� aY
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O co UJ
File #
Applicant Name
Project Address
M a)v
a ELL O o
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t- to
W = U) U)
OI 10-40
Leon Capel
216 SW 15th St
storage
7/7/2011
ES
Ol 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
7/2012011
O.H
RECEIVED
VVII:MINtT-­
OCT 1
Return To: Division of Coastal Management
127 Cardinal Dr. Ext.
Wilmington, NC 28405
Signature 4�yu�,_�
Date: 10/ 13/2011
Telephone: -910 201-8047

REQUISTION FOR PAYMENT
OF CAMA MINOR PERMIT PROGRAM
IMPLEMENTATION AND ENFORCEMENT
Local Government: 0"q- 161'�i JY->
Period Covered: X I" Quarter (July - Aug - Sept)
FY: 2011-2012 2nd Quarter (Oct - Nov - Dec)
3rd Quarter (Jan - Feb - Mar)
4th Quarter (Apr - May - Jun)
Services Rendered:
� oa
OH S ES _ /-3 Permits processed @ $55.00 each $ /
(Cities and towns)
OH ES = Permits processed @ $75.00 each $
(Counties)
-� Do
OH 0 ES = Final Inspections @ $40.00 each $ ,
OH// ES / _ /vZ Exemptions investigated @ $25.00 each $ 300.00
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 payme .
DCM Region Repres tative
Date: /0 -/ - / /
DATE RCVD IN WILMINGTON OFFICE: /0 -01 -//
DATE SENT TO MOREHEAD CITY OFFICE:
DATE PAID: