OI 12-15-HAYWOOD

I/
Oak Island ill 112-15
Local Govemment Pet nit Number
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 1,13A-118 Of the
General Statutes, "Coastal Area Management"
issued to Edgar Haywood 111, authorizing development in the Ocean Hazard (A —to) at 717 countirvi"Cl lub Dr., in ow
Island, as requested in the permittee's application, dated 302/2012. This permit, issued on 3/qkQ12, is subject to
compliance with the appfication and site drawing (where cm, sistent with the permit), all app4o", regulations and
special conditions and notes set forth below, Any violation of these terms may subject permittee to a Me, imprisonment
or 641 action, or may cause, the per -lit to be null and void.
Th
is his permit authorizes: the development of additional 10' x 30' deck, landing & stairs with associated development,
ill All Proposed developnnent and associated construction must be done in accofdanoe with V-ie permitted work plat
drawinqs(sI � elated received
on 3.11212012,
(2) All corwriction mW, conform to, tie jU,r;. Building Codie requirefrierits and all ot,t� local; Mate and Fe(ienll regulations,
applicable local ordinances and FEKA F" Regulations.
Any chat ge, or changes in the plans, for development, oastWn, or land u% activities will require a re-evaluation arxi
rnodft i ation of this po rmit.
(4) A copy of this permit shall be posted or available, 041 site, Contact this office at [phone] th a final inspecbori at
oompietion of work.
(Acdditionel Permit C'ondlitions ort Page 21 RECEIVED
DCM WILMINGTON, NC
APR 2 3 26Q
This perrnit action may be appA-ed by the Permittee Or other qualified persons
within Wanly (20) days of the issuing date. Frew the date of an appeA, any
"A cOndwted Urdbr this PP.rinft rarest cease until the appeal is resolved, This
Pam* must be on the pro slitte and accessilk to the permit offim Man the
Project is inspected for compliance, Any maimenanoe work or prqect
M44ficatiori not covered under this permit, repre further w Perm
I men it
approvai. Ati work must cme when this permit expirw on:
DECEMBER 31, 2015
IT) issuing this permit it is agreed that this pmjw, is Wnsistent with t [=
he , al Land
Usc= Plan and 84 applic" ordinaves. This pffm# may not be transferred to
another party without the wrifteAl aWovai of tile Division of Coastal
Martagerrient
Donna F. Coternari
CAMA LOCAL PERMIT OFFICIAL
4601 E. Oak island Dr.
0 1 )Isla; d, NC 28465
7-P
PERM1117EE
(Signature required if conditions abof* apply to permit,,)

X�2
7 Minor Permit # Of 12-15
r Date, X/30/2012
Page 2
(5) The structure must set back minimum of 150 feet from the first line of stable natural vegetation, as determined by
the DCM, the LPO, or other assigned agent of the MR
(16) The pmitt ee is required to contact the ,'Local Permit Officer [phone], shortly before tie plans ic, begin
construction to arrange a setback measurement that will be effective for sixty 1`60) days barring a rnajor shoreline
change. Construction must beqin witnin sixty (60) days of the determination or tree measurements is void and most
be redone.
All buildings constructed within docean hazard area Shall comply with the NG Building Code, including the
Coastal and Flood Plain Construction Standards of the N. C. Building Code, and the Local Florad Darnage
Prevention Ordinance as required by the National Flood Insurance Program, if any provisions of the building code,
or a flood damage prevention Ordinance are inwrlsiritent vAth any Of the following AEG standardis, the, more
restrictive provision shall control,
(8) All buildings must he elevated on pilings w,#, a diameter of at legit 8 inches in diameter if round, or 8 inches to a
site if square; and the first floor level of the sills and joists must rrwi the I 00-year " level elevation,
(9) All piling; shall have a tip penetration greater than eight feet Wow the lowest ground elevation under the, stricture.
0 O)Durte di0turbances 01 be allowed only to the extent necessary for development and if the dune's protective value is
riot weakened or reduced. Disturbed dune areas will te irntTrediately stabilized.
1)AA unconsolidated materiai Fesufti.rq from associated grading and landscaping shall be retained or, site by ef�,c6%
sedimentation and erosion c;onljrjl rneasuv-s. Disturbed areas shall be vegetatati,,ely stabilized 'Planted and
MuICW) within 14 days of construction completion. I k I
(12)Any strucW authorized by this perm# shaft Ix, rekyated or dismantled when it becomes imminently threatened by
changes in shoreline configuration. -TILSLU'turef§j�h -—c— I all be relq,tee of dignanfied within, 1, Lytars of the time
When it becomes imminently threatened artd ` I
Hower, if natu-;."ve
snoreline recovery or beach menourishnrient t8ke-S, PIRC-e '011in Wo years of the time the structure becol-fles
imminently threaten , so that the strixti-;re is no 109K imminently threatened, then;it need tot be 'relocated or
dismantled at that time, This owidition shall not 0,"-, the permit ho'ldefs right to seek authorization of tem ponary
PrOterijve m, easunes allowed under CRC rule,,,
RECEIVED
DCM WILMINGTON, NC
APR 2 3 202
-SIGNATUPE:
P E RK7 T HE

IM(�'�t�t�i�}. �G-+r^ ,�ww����ii %�` , s?:'i•3±1�1 i°`��.'s'`�$�.3ar:
(Icearr'.ta rd ' Est�.r€r ar. htrcii x_ tr>r lira..__.Paabli, :rust Shrareh - Other
LANDOWNER'
Narne C.(— 1-A
Address J
State ip Phone
Name i-
City t. '" ...._� tate �, Zip 7. i4c0 { phone L l
�-� �cc
1:0CA ION OIL PROJECT: (Address, street name and/or directions to site. If not oceai� rcmt, vvlra.t is the name of the
adjacent � rated)r dy. __1ri
"3Co __ , C_0,,C � `ll''1 ` ti r-o"i�r,� �.
DESCRIPTION OF PROJECT: fl-ist all proposed construction and tand disturbance.)
SIZE OF LOT/PARCEL: � .).��� square .feet _ acres
PROPOSED I,'S :a Residential _ (S e te-farnily- _:Multiwfarnily ) Commerc; al%I.ndustrial
other
ENVIRON-
MENTAL CON(' N (AE '1: � � square feet (includes all floors and roof covered decks)
SIZE OF lli: Il .l ING FOUITRINT AND t ` HER IMPERVIOUS OR, MULT-UPON St IN THE
(70AS AL II II :I INE A ll. :NV I ,CrN f NT 1: CONCERN (AE( ......... �`'��.._.._.. s,4oare feet
(Calculations i.acludes the area of the roofl rip line of all buildings, driveways, covered decks, corer to ormasonry p'S'
etc., that are within the applia.:abl(( ,._. IX. Attach your calculations with the project drawing
Chofte the AEC area that 4pplies to yonr° property:
tl�rt,E: � �-�rl#~tifi�ar�g�rn��a��at�u.t..evelfor�:��tf.�,rrinc�$rotell e:;,�ECEiVED
a o )t;,tirl;l tfi-h 'at«/ 1,4omal Water Ceti; 13 Estu'%'ine Shoo 1V1 �MjN,.9TQNNC
APR 2 3 2012
f j w <tlis„ O f eet : �1 1-1ig ,Va r,' Normal eater i,e ;"t ' � ,'>1 t st Shoreline, AAC
•'4.' . i'ta.".. t.t#ti;; _. s % .; ,.. rt bz k;t . �tr prop
STATE STORNINVAYER PERMIT —I,
�Iu�at�<$r��caart l'�rrt�tr t•`1��e,cl h�;= t1_� �"�_ �)[ <�.sir�.t cri ���ater 4���:
NO
square- fiat.

OTHER PER.MrIPS MAY BE REQUIREM Th,- activity you are planTliligy n'jay iNvir-, pennits other than the CAMA ininer develop.•
inent perinit. As a servioz, vve have compiled a listing of the kinds- of perrnits that might be requircd� We suggest C I beck over The l»st
with your L.170 to deterrnini-, if any of these, Ipply to your prt?ject, Zoning, Drinki vg 'Water Well, Septic Tank (or utticr swijwy waste
treatment system), Btiilding, Electrical, Plumbing, 1-te"aiting and Air Conditioning, fnsulation and Eawgy Conservation, FIA C"ertification,
Saad Mine, 13,edinient Control, Subdivision Appawal,Mobiile Tion'te Park Approval, Highway Coraiwin., end cthcrs.
STAJEMENT Of, OWNERSIIIP-
1, tho undersigned, an applicant for a CAMA minor devetopu'terit permit, being aitber the owner of jlnopero "I in z�n A.EC
or person author to act awo s agent Bor purposes of applyirig for a CA MA mirtor development petmit, ctrtj fy that the per,on
listed as larldoveer on d.iis applivation bas a Significant intert'st in the real property described therekin. Tiiis can [-,,e
described as-. (check one)
.//an awner or record title, Title is vested hi ;4. - Tt&LWYe,
page see Deed Book
in tht County 11-tegistry of Deeds,
... .. ........
. . ....._an owner by virtue of inheritance, Applicant is an heir to the, estate of
........... . . - . ................
probate was in . ............................ County.
41.
if other interest, such as written contract or lease, explain below or use a separate sheet & aft-fteb to this application.
NOTIFICATION OFATITACENT PROPERTY OWNER$::
I furthermore certify that the following persons are oar nars of properties adjoining this property. I affirm that 1 have givell
ACTUAL NOTICE to each of them concefillng tily intent to develop this praperiy and to apply fora CANIA perit
(Name) (Address)
ilk
FOR DEVELOPE RS IN OCEAN.HAZARI) AND ESTUARINE HAZARD AREAS:
,I acknowledge that the lartd owner is aware that the proposed development is planned for an area which lmay b!! slisceptible
to erosion and/or Rootag, I acknowledge that t1he local permit officer has explained to nic the pani
associated with this lot. This expAarlation was accompanied by recommendations conceminn ysl,ir 11.1-1
technique,
I � %1�1 ,
PE RMISSION TO ENTER ON LAND: APR 2 3 2012
I fw-alermore Cartifv that I am authorized to _pant and do in fact grant peariission to the local permit officer and his agents to
eaten rill thea-forcmentioined lands in cor ,,non with evalualing information relatW to this permit application,
71 his applica6orl includes: grs)!
I ' M'on (t4is form), a site drawing as described on the back of this applicatiar, the
(Ywrlership statemo-ut, the AEC bu.:,,., �1 Od"e WIN -,re neces&LrY, a check for S100M made Payable to the!ocalftv and any
information as may biprovided, oral )e appli.7a-iit, TMe detai i's of the 3pplicatknn ss described by -these spumes a-r-
incorporated without refemace in are,, wilie. issaad. Deviadon frora these details will constitute a violation
of any pennit. Any person developin:, 7'cwith" ": pelniit i,� subject to cl vi ,zim, inal anid adnainistrati ve acticin-

AEC HAZARD NOTICE
Project Is In An: Ocean Erodible Area High Hazard Flood Area Inlet Hazard Area
Property Owner. n l A
Property Address: cj:„ r—,-y� ,Ir°
Date Lot Was Platted: _ ,!:1 L.I
This notice is intended to make you, the applicant, aware ofthe
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 5 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
_feet landward in a major storm.
The flood 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 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 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 afler permit expiration.
For more information, contact. -
Local Permit Officer
Address
L Ts af,�y Z �l cis
Locality
(5� 10) 2_..OI -SC 4i
Phone Number
RECEIVED
DCM WILMINGTON, NC
APR 2 3 AQ
Ap ca ignature Gate
Revised

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at -c-lul-c6-i'MA
Address. Lot, Black, Road, etc,)
on h-H4ALC-0-cc--al, in OA-TS6� , 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.
(ATI-ICAILO-N AND DRAWING 0E-FT-0-P9SED DEVELOPMENT ATTACHED)
SiAna re
T
Print or Type Nat& - '- ' - I
Telephone Number
. -Lip.
100'r-
Date
RECEIVED
DCM WILMINGTON, NC
APR 2 3 2612

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2113112
(176 unread) att.net Mail, ahearnc@abeilsouth_net
RECEIVED
DCM WILMINGTON, NC
APR 2 3 tUt
us.mg244.mail_yahoo.com/dcliaunch?.partner—sbc&.gx=1 &.rand=5mt9g63o42mcn 112

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,ECEIVED
WILMINGTON, NC
APR 2 3 �G12
z3eO03e

ADJACENT RIPARIAN PROPERTY OWNER
STA,rEMEN-r FOR CANIA MINOR PERMITS
I hereby certify that I Owl' Property adjacent to = i
-t-ATor----
(Name of Property Owner)
property located at
Address, Let, Block, Road, etc.)
C
on
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, t have no objections to his proposal.
(APPLICAT:ION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
.............
// ,5 e-tA
Print or Type AN�am, ' ---- -1:7
9c� Y C241 q 7 Y.;PZ.,-
Telephone Number
15//
Date
RECEIVED
DCM WILMINGTON, NC
APR 2 3 2012

I
,---w,---
NOTICE OF FILING OF APPLICATION
FOR CAMA MINOR DEVELOPMENT PERMIT
Pursuant to NCGS I I 3-A- I 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
Address
Development
Comments through
01 12-10
John & Kimberly Gift
2618 E. Beach Dr,
enclose existing deck
March 23, 2012
0112-11
Richards/Audefte
123 SE 76hSt
driveway
March 30, 2012
01 12-12
Brian Keesee
5524 E. Beach Dr.
demolition
March 30, 2012
0112-13
01 Elks #2769
106 E. Dolphin Dr,
self contained ice machine
March 30, 2012
0112-14
William Milby
6910 W. Beach Dr.
poolffence
March 30 2012
0112-15
Edgar Haywood
717 Country Club Dr,
deck
March 30, 2012
Donna Coleman
CAMA Local Permit Officer
Town of Oak- Island
4601 E. Oak Island Dr.
Oak Island, NC 28465
Phone: [phone]
PLEASE PUBLISH ON: March 14,2012
Billing information for this ad.
Cathy Robbins
Town of Oak Island
4601 E. Oak Island Drive
(tale T-aNnA NC ")R4A';

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
1130E Dolphin Dr
1/27/12
. 1/6/12
2/9/12
2/3112
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
3/16/12
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
Richards/Audette
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
3/8/12
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
8/3/42
- 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
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Applicant Name
Project Address
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OI 11-41
Johnny Newton
6602 E. Yacht Dr.
1211512011
12/21/2011
12/19/2011
1/6/2012
ES
0- demolition
01 11-42
Christopher Flanders
1904 E. Dolphin Dr.
12/22/2011
1/4/2012
116/2012
1/13/2012
OE
SFR
OI 11-43
WH Odell
5103 W Beach Dr.
12/15/2011
12121/2011
12/1912011
116/2012
OE
0 - Driveway
01 12-01
John Davenport Jr.
6020 W. Beach Dr.
1/5/2012
1/11/2012
1/6/2012
1/27/2012
OE,CS
0 - Addition
OI 12-02
i_ar & Chichi Hodges
1130 E. Dolphin Dr.
1/10/2012
1/18/2012
1/24/2012
21312012
OE
0- Retaing wall
OI 12-03
Mary Pennington
1426 E. Beach Dr.
1/19/2012
1/25/2012
1/2412012
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
1/26/2012
1/24/2012
2/1/2012
N C
SFR
OI 12-06
George Brannon
3307 W. Beach Dr.
218/2012
2/15/2012
2/9/2012
3/2/2012
OE
SFR
01 12-07
Johnny Newton
6602 E Yacht Dr.
2/8/2012
2/15/2012
2/9/2012
2/27/2012
CS
SFR
01 12-08
Chad Morris
1404 W. Yacht Dr.
2/27/2012
2/29/2012
3/112012
3/1612012
CS
0 - landsca in
01 12-09
Mary Beth & Dan Evers
602 E. Beach Dr.
2/23/2012
2/29/2012
3/1/2012
3/16/2012
OE
SFR
01 12-10
John Clift
2618 E_ Beach Dr.
2/29/2012
3/14/2012
3/1/2012
3/23/2012
OE
0 -enclose deck
01 12-11
Richards/Audette
123 SE 67th St.
3/7/2012
3114/2012
3/9/2012
3/30/2012
OE
0- driveway
01 12-12
Brian Keesee
5524 E. Beach Dr.
3/8/2012
3/14/2012
3/9/2012
3/30/2012
OE
demolitionMil
01 12-13
10 Elks #2769
106 E. Dolphin Or.
3/8/2012
3/14/2012
3/9/2012
3/30/2012
OE
0 - ice machine
01 12-14
William Miiby
6910 W. Beach Dr.
3/9/2012
3/14/2012
3/9/2012
3/30/2012
0E,HHJH
0 -pool/fence
OI 12-15
Edgar Haywood
717 Country Club Dr.
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 S.
Date: 4/22/2012
Phone Number: ck, �5(>49
RECEIVED
APR 2 3 2012
13C:IM WILMINGTON, NC

��`� .Yl i.: �C�1 �i PtVi.i i�l4' _

REQUISTION FOR PAYMENT
OF CAMA MINOR PERMIT PROGRAM
IMPLEMENTATION AND ENFORCEMENT
Local Government: 16-IiJb
Period Covered: I" Quarter (July - Aug - Sept)
FY: 2011-2012 2nd Quarter (Oct - Nov - Dec)
X 3rd Quarter (Jan - Feb - Mar)
4th Quarter (Apr - May - Jun)
Services Rendered:
OH @ ES 4 _
Permits processed @ $55.00 each
(Cities and towns)
OH_ ES = Permits processed @ $75.00 each $
(Counties)
OH oZ ES 3 = S Final Inspections @ $40.00 each $ c200
OHS ES__3 _ c2 Exemptions investigated @ $25.00 each $
OH ES = Violations resolved @ $100.00 each $ lD oci
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 payment.
DCM Regional k4resentative
Date: 11-,23
DATE RCVD IN WILMINGTON OFFICE: ;/-d 3 --/.L-
DATE SENT TO MOREHEAD CITY OFFICE:
DATE PAID: