OI 11-43

V
Oak Island
Local Govemment
Ica=
I Y-79' 1-1 H I h, P M1, !7; a
11:10-
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'
Ts—su�d—t6-WH Odell, authorizing development in the Ocean Hazard (AEC) at 5103 W. Beach Dr, , in Oak Island, as
requested in the permittee's application, dated 12/29/11, This permit, issued on 1/1312012, 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: a driveway with associated development.
(1) All proposed development and associated construction must be done in accordance with the permitted work plat
drawings(s) dated received on 1212912011.
(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 permft,
(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
pitijed 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:
in issuing this pen -nit 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
PERM ITmWiLCAN-,
4601 E. Oak Island Dr,
Oak Island, NC 28465
PERMITTEE
(Signature required if conditions above apply to permit)

Name: Wit Odell
Minor Permit # 0111-43
Date: 111312012
Page 2
(4--T6e -structure must set back a minimum of 60 feet from the first line of stable natural vegetation, as determined by
the DCM, the LPO, 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 driveways 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 )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.
(9) All 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 O)Any structure authorized by this permit shall be relocated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. The structures ) 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 renourishment 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 relocated 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.
P rL V
2012
64C
SIGNATURE: DATE:
PERMITTEE

Permit Number �-
Ocean i award stilarine Shoreline - - O Shoreline llublic Trust Shoreline Other .
. _
(l°«r cpJ'licial € se only)
LAND OWNER
Name: 14 -
Address: a 1 t
i city:®%
`„-a t `� State. Phone:
e.._� Tip:
��i VA � 7�C�i'tMil ail
Name:
Address:
City: State: _ Zip: __ Phone:
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, That is the name of the
adjacent waterbody,) ,J,
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) <Ji i i-r
SIZE OF LOT/PARCEL: ro square feet acres
PROPOSED USE: Residential ® (Single-family ® Multi -family FI) Commerical/Industrial Q Other ❑
TOTAL ENCLOSED FLOOR AREA OF A BUIJLDING IN THE OCEAN HAZARD AREA OF
ENVIRONMENTAL CONCERN (AEC): ` � square feet (includes all floors and roof covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT-LTI"ON SURFACES IN THE
COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): square feet (Calculations
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 .)
Choose the AEC area that applies to your property:
(l)within 75 feet of Normal High Water for the Estuarine Shoreline AEC
(2)within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters
(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 property.)
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 {duality? YES ❑ NO Q
If yes, list the total built upon area/impervious surface allowed for your lot or parcel. square feet.
kkCEIVEu
JAN 0 9 2012
""_—M WILMINGTON, NC

WTI,, " k? "�'
NOTICE OF FILING OF APPLICATION
FOR CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS 113-A-1 19(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
0111-42 Christopher Randers
01 11-43 W H Odell
Address
1904 E. Dolphin Dr
5103 W. Beach Dr
Development
single family residence
driveway 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: January 4,2012
Billing information for this ad:
Cathy Robbins
Town of Oak Island
4601 E. Oak Island Drive
Oak Island, NC 28465
Comments through
January 13,2012
January 13, 2012
CEIE D
JAN 0 9 2012
DCM WILMINGTON, NC

OTHER PERMITS MAYBE REQUIRED: The activity you are planning may require permits other than the CAMA minor development 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, Heating and Air Conditioning, Insulation and Energy Conservation, rIA Certification, Sand Dune, Sediment Control.
Subdivision Approval, Mobile Home Park Approval, Highway Connection, and others.
STATEMENT OF OWNERSHIP:
J, 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 for a 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)
L
an owner or record title, Title is vested in *H 'Vl� -q
see Deed Book
page .L4� m the&iAi�lkounty Registry of Deeds.
❑ an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in - County.
F] if other interest, such as written contract or lease, explain below or use a separate sheet and attach to this application.
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 LAMA permit.
(Name) (Address)
4PLU'J'-4 O-Zib- CA
(2) CL �X- 2-710-C-1
(3)
(4)
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 floodproofmg techniques.
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 hazard 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 AEC without permit is subject to civil, criminal and administrative action.
RE C. finis the 2-CA day of..Pee-, 201 t
JAN 0 9 2012
TON, NC Landowner or person authorized to act as his agent
jfi WILMING
I �for purpose of filing a CAMA permit application

AEC HAZARD NOTICE
project IsInAn: _,.._Z Ocean Erodible Area -" - High Hazard Flood Area Inlet Hazard Area
Property Owner: La�
Property Address: 1"J
Date Lot Was Platted: J_Faw' .
M
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 ifthey 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 a 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
3a.5- feet landward in a major storm.
The flood waters in a major storm are predicted to be about
I la 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 signing this notice in the space below. Without the proper
signature., the application will not be complete.
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 of the
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 rerneasurement 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:
—Do t1-J i�lj A
J I cf! (Y\
Local Permit Officer
4(,ol E,
Address
Locality
(910) Qoi_ 18049
Phone Number
JAN 0 9 2012
'�CM WILMINGTON kl(-
Z-7--
Applicant Signature
Date
W�175 I

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CAMA rXIIJAN
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TOW
(CAMA
RECEIVED
J N 0 9 212
U)
LLCM WILMINGTON, NC
Existing
Foundation
Oil
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2. B. 5' Lot
6,079±'
Zq'
Cul IaA N
r&jj,*jA
West Beach Drive

Receipts for
Cerfified Mail
(Staple Here) I
Date
UC—
A01centPro rtyQv5 er
rt
J._ _ _I ?-LA —
Uniting eS13
City, State, Zip Code
Dear Adjacent Property:
This letter is to inform you that 1, —AALCCL-:�i t have applied for a CAMA Minor
Property Owner
Permit on my property at in Brunswick
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 a, or by mail at the address listed below, If you wish to
Applicant's Telephone
file written comments o; objections with the Town of Oak Wand CAMA Minor Permit Program, you may subm it
them to:
Donna Coleman
Local Permit Officer for the Town of Oak Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Sincerely,
Property Owner
`-U-2- Mc I Lo
Mailing Address
E C �tt-
City, State, Zip Code
PFC-EIVED
JAN 0 9 2012
D 1�
CM WILMINGTON, NC

Customer Receipt
(For use by Rural Carders and #ftlrway Contract Routes only)
Amount (Written Out)
1100 Dollars
Check Here for Temporary Receipt Amount (In Numbers)
(Payment Received -- Total Cost Not $ e',
Yet Calculated) )-
Purpose
By
PS Form 1496, October 2009 PSN
Customer Receipt
(For use by Rural Carders and Highway Contract Routes only)
Amount (Written Out)
1100 Dollars
Check Here for Temporary Receipt Amount (In Numbers)
(Payment Received -- Total Cost Not 3
Yet Calculated)
Purpose
By (Signature) Date (MMIDDlYYYY)
PS Form 1096, October 2009 PSN 7530-02-000-7346
Ci
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co
Ln `k �.._. � ►r! Pram `•k'
rlutftbd m1fivary roe
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7

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te
13 t
Spo,
Adjacent Prole, 'ner
n A ss
c4a-11 'If-, Q�
City; State, Zip Code
Dear Adjacent Property:
Receipts for
Certified Mail
(Staple Here)
0 1 8
This lefter- is to intiOrm you that 1, K, x il, have applied for a LAMA Minor
Property Owner
Permit on my property at in Brunswick
Property Address
County; As requited 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 U.
L�- I 1'�—� 9-- _._,........:or by mail at the address listed belowif you wish to
Applicant's Totephone
file wqitten comments or obieclionq with the the I own of Oak island LAMA 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
Sincerely,
Property Owner
a4et U-,
Mailing Address
City, State, Zip Code
RECEIVED
JAN 0 9 2012
ACM WILMINGTON, NC

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
QI 11-42 Christopher Flanders
01 11-43 W H Odell
Address
1904 E. Dolphin Dr
5103 W.Beach Dr
Development
single family residence
driveway 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: January 4, 2012
Billing information for this ad:
Cathy Robbins
Town of Oak Island
4601 E. Oak Island. Drive
Oak Island. NC 28465
Comments through
January 13, 2012
January 13, 2012
4 T 'EIVED
0 9 2012
`"�J,AINGTON, NC

CAMA Minor Permit
Log 2011-2012
Oak Island
Wiro / Pg. 1
Date Quarterly report received: 4-23-12
3rd 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
Date RO
rcv'd
Public
Notice
AEC
App
Complete
Appr. for
Payment
11-41
Newton, Johnny
6602 E Yacht Dr
1/9/12
11/10/11
1/9/12
1/6/12
12/15/11
1/9/12
n/a
Y
Y
11-42
Flanders, Chris.
1904 E Dolphin Dr
1/9/12
12/20/11
1/9/12
1/13/12
12/22/11
1/9/12
Y
Y
Y
11-43
Odell, W H
5103 W Beach Dr
1/9/12
12/29/11
1/9/12
1/13/12
12/29/11
1/9/12
Y
Y
Y
12-01
Davenport, John
6020 W Beach Dr
2/2/12
1/4/12
2/9/12
1/27/12
1/5/12
2/2/12
Y
Y
Y
12-02
Hodges, Larry
1130 E Dolphin Dr
1/27/12
1/6/12
2/9/12
2/3/12
1/10/12
1/27/12
Y
Y
Y
12-03
Pennington, Mary
1426 E Beach Dr
1/27/12
1/12/12
2/9/12
2/10/12
1/19/12
1/27/12
Y
Y
Y
12-04
Surratt, Todd
1110 E Dolphin Dr
1/27/12
1/20/12
2/9/12
2/10/12
1/20/12
1/27/12
Y
Y
Y
12-05
Brewer, Gary
5908 E Yacht Dr
1/27/12
1/14/12
2/9/12
2/6/12
1/20/12
1/27/12
n/a
Y
Y
12-06
Brannon, George
3307 W Beach Dr
3/16/12
2/6/12
3/16/12
3/2/12
2/8/12
3/16/12
Y
Y
Y
12-07
Newton, Johnny
6602 E Yacht Dr
3/16/12
2/22/12
3/16/12
2/27/12
2/8/12
3/16/12
n/a
Y
Y
12-08
Morris, Chad
1404 E Yacht Dr
3/16/12
2/21/12
3/16112
3/16/12
2/27/12
3/1.6/12
n/a
Y
Y
12-09
Evers, Marybeth
602 E Beach Dr
3/16/12
2/22/12
3/16/12
3/16/12
2/23/12
3/16/12
Y
Y
Y
12-10
Clift; John
2618 E Beach Dr
4/20/12
2/28/12
4/20/12
3/23/12
2/29/12
4/20/12
Y
Y
Y
12-11
Rich ards/Aud ette
123 SE 67th St
4/23/12
3/7/12
4/23/12
3/23/12
3/8/12
4/20/12
Y
Y
Y
12-12
Keese, Brian
5524 E Beach Dr -
3/16/12
3/7/12
4/23/12
3/23/12
3/8/12
3/16/12
Y
Y
Y
12-13
OI Elks Lodge2769
106 E Dolphin Dr
3/16/12
3/8112
4/23/12
3/21/12
3/8/12
3/16/12
Y
Y
Y
12-14
Milby, William
6910 W Beach Dr
4/23/12
8/3/12
4/23/12
3/30/12
3/9/12
4/23/12
Y
Y
Y
12-15
Haywood III, Edgan
717 Country Club Dr
4/23/12
3/22/12
4/23/12
3/30/12
3/22/12
4/23/12
Y
Y
Y

LPO COMPOSITE RECORD FORM FOR MINOR PERMITS
LOCALITY: Oak Island FOR QUARTER: 3rd Year: 2012
T W
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tl
Fite #
Applicant Name
Project Address
N
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C N n
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"! _
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4t
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C1 N O
as � O
a N U
OI 11-41
Johnny Newton
6602 E. Yacht Dr.
12/1512011
12/21/2011
12/19/2011
1/6/2012
ES
O- demolition
01 11-42
Christopher Flanders
1904 E. Dolphin Dr_
12/22/2011
114/2012
116/2012
1/13/2012
OE
SFR
Oi 11-43
WH Odell
5103 W. Beach Dr.
12/15/2011
12/21/2011
12/19/2011
1/6/2012
OE
0 - Driveway
01 12-01
John Davenport Jr.
6020 W. Beach Dr.
115/2012
1/11/2012
1/6/2012
1/27/2012
OE,CS
O - Addition
01 12-02
Larry & Chichi Hodges
1130 E. Dolphin Dr.
1/10/2012
1/18/2012
1/24/2012
213/2012
OE
O- Retaing wall
01 12-03
Mary Pennington
1426 E. Beach Dr.
1/19/2012
1/25/2012
1/24/2012
2/10/2012
OE
0- landscaping
01 12-04
Todd Surratt
1110 E. Dolphin Dr_
1/20/2012
1/25/2012
1/24/2012
2/10/2012
OE
0 - Clear/Fill
01 12-05
Gary Brewer
5908 E. Yacht Dr,
1/20/2012
1/25/2012
1/24/2012
2/1/2012
N C
SFR
01 12-06
George Brannon
3307 W. Beach Dr,
2/8/2012
2/15/2012
2/9/2012
31212012
OE
SFR
01 12-07
Johnny Newton
6602 E. Yacht Dr.
2/8/2012
2/1512012
2/912012
2/2712012
CS
SFR
01 12-08
Chad Morris
1404 W. Yacht Dr.
2/27/2012
2/29/2012
3/1/2012
3/16/2012
CS
0 - landscaping
Of 12-09
Mary Beth & Dan Evers
602 E. Beach Dr.
2/23/2012
2/29/2012
311/2012
3/16/2012
OE
SFR
Ol 12-10
John Clift
2618 E. Beach Dr.
2/29/2012
3/14/2012
3/1/2012
3/23/2012
OE
O -enclose deck
Ot 12-11
Richards/Audette
123 SE 67th St.
317/2012
3/14/2012
3/9/2012
3/30/2012
OE
0- driveway
Of 12-12
Brian Keesee
5524 E. Beach Dr.
3/8/2012
3/14/2012
3/9/2012
3/30/2012
OE
demolition/fill
OI 12-13
10 Elks #2769
106 E. Dolphin Dr.
3/8/2012
3/14/2012
3/9/2012
3/30t2012
OE
0 - ice machine
01 12-14
William Milby
6910 W. Beach Dr. 1
3/9/2012
3/14/2012
3/9/2012
3/30/2012
0E,HHJH
0 ool/fence
01 12-15
Edgar Haywood
717 Country Club Dr. 1
3/12/2012
3/14/2012
3/9/2012
3/30/2012
OE
0 -deck
Return To: Division of Coastal Management
127 Cardnial Dr. Ext
Wilmington.. NC 28405
Signatur .
Date: a/ 2/2a1z____
Phone Number: 910 Z'r-4
I ECEIVED
APR 2 3 2012
t)CM WtLMINGTON, NC

REQUISTION FOR PAYMENT
OF CAMA MINOR PERMIT PROGRAM
IMPLEMENTATION AND ENFORCEMENT
Local Government: Lf, 1S&R1,)h>
Period Covered: I" Quarter (July - Aug - Sept)
FY: 2011-2012 2nd Quarter (Oct - Nov - Dec)
X 3rd Quarter (Jan - Feb - Mar)
4tn Quarter (Apr - May - Jun)
Services Rendered:
OH1 ES 4 Permits processed @ $55.00 each
(Cities and towns)
OH ES = Permits processed @ $75.00 each $
(Counties)
OH aZ ES J = Final Inspections @ $40.00 each $_(�C�
OH24 ES _ ; 4- Exemptions investigated @ $25.00 each $
OH ES = Violations resolved @ $100.00 each $ 600,
LPO Training (not to exceed $200.00) $
TOTAL AMOUNT REQUESTED UNDER THIS REQUISITION $ / Tg 0,
The above information is an accurate account of activities carried out by the local government
staff during the period specified above. I approve for payment.
I
DCM Regional resentative
Date: 'I ;2,3 —/-A,
DATE RCVD IN WILMINGTON OFFICE: Zl-d,3
DATE SENT TO MOREHEAD CITY OFFICE:
DATE PAID: