SW7060714_HISTORICAL FILE_20200602

STORMWATER DIVISION CODING SHEET
POST -CONSTRUCTION PERMITS
PERMIT NO.
SW�I��/ID7��
DOC TYPE
El CURRENT PERMIT
❑ APPROVED PLANS
HISTORICAL FILE
DOC DATE
:2oo)-oD(a6a
c
YYYYMMDD

ROY COOPER
Governor
MICHAEL S. REGAN
Serra-y
BRIAN WRENN
Director
NORTH CAROLINA
Environmental Quality
June 2, 2020
County of Pasquotank
Attention: Mr. Sparty Hammett, Manager
206 E. Main Street
Elizabeth City, NC 27909
Subject: Stormwater Permit Renewal
Stormwater Management Permit SW7060794
Albemarle District Jail
Pasquotank County
Dear Mr. Hammett:
A Division of Energy, Mineral, and Land Resources file review has determined that
Stormwater Permit SW7060714 for a stormwater treatment system consisting of a wet
detention pond serving Albemarle District Jail located at 210 South Executive Drive
Elizabeth City, NC expires on November 20, 2020. This is a reminder that permit
renewal applications are due 180 days prior to expiration. We do not have a record of
receiving a renewal application.
Please submit a completed permit renewal application along with a $505.00 fee for
permit renewal. Also, it was noted in the file review that a designer's certification that the
project was constructed in accordance with the approved plans as required by the
permit has not been submitted. Please include this with your application. Permit
application forms,for renewal can be found on our website at:
his://�ar-
deq.nc,gov/abo�ldivisions/energy-miner 1-land-resources/energy-mineral-land-
rules/stormwater-nro/_o-ost-construction. North Carolina General Statutes and the
Coastal Stormwater rules require that this property be covered under a stormwater
permit. Failure to maintain a permit subjects the owner to assessment of civil penalties.
If you have questions, please feel free to contact me at [phone]. 1 will be glad to
discuss this by phone or meet with you_ If you would like, I can e-mail you a copy of the
application form. You can request a copy by e-mailing me at [e-mail].
Sincerely,
Rog6r K. Thorpe
Environmental Engineer
ME QNorth� Carolina Department of Environmental Quality I Dmslon of Energy, Mineral and Land Resources
Washington Regional Office 1 943 Washington Square Mall I Washington, North Carolina 27889
252.946,6481

'^ _,,.
/MICDOWELL & ASSOC/ATES,P.A,
JA(a £NG/MEERS•SURVEYORS
Post Office Box 391
1715 Weeksville Road
Elizabeth City, NC 27907-0391
William P. McDowell, III, P.E., R.L.S.
Telephone: [phone]
Fax: [phone]
November 20, 2006 ./e_ / 5�,� p6 v 7 /l
Mr. William J. Moore G1115(07 C�®
Environmental Engineer � �'!� V LS
Department of Natural Resources NOV 21 2006
943 Washington Square Mall
Washington, NC 27889
RE: Stormwater Permit for: I�
Proposed Albemarle District Jail
RE:
7, Section C, Pasquotank County Commerce Par
Dear Mr. Moore:
As we discussed last Thursday in our office, 1 have made the following revisions, and I am
sending to you two (2) copies of the revised Sheet C1.05:
A. Revised the proposed 4" orifice configuration at its inlet to provide for easier
cleanout, with a removable plug above the water surface of the design temporary pool
elevation.
B. Specified wetland species plants to be planted around the perimeter of the 10' shelf.
Please let me know if you should need any additional information in order to complete your
review.
Sincerely,
Don A. Bunch
Engineering Technician
DAB/rae
Enclosures
CC: Mr. Rodney Bunch, Assistant County Manager
Mr. Randy Cartwright, Sheriff
Mr. James Ruckman Architect (w/ enclosures)

McDOWELL & ASSOC/ATES,P.A.
J%b ENGINEERS, SURVEYORS
Post Office Box 391
1715 Weeksvi e Road
Elizabeth City, INC 27907-0391
July 24, 2006
Mr, William J. Moore
Environmental Engineer
Department of Natural Resources
943 Washington Square Mall
Washington, NC 27889
RE: Stormwater Permit for:
Proposed Albemarle District Jail
Lot 7, Section C, Pasquotank County Commerce Park
Dear Mr. Moore:
William P. McDowell, Ili, P.E., R.L.S.
Telephone: [phone]
Fax: [phone]
AUG 2 :3 2006
DWQ-WAS
Enclosed please find for your review and approval, the following information on the above
referenced project:
1. Two (2) copies of an executed Stormwater Pert -nit Application, Form SWU-101
and Wet Detention Basis Supplement, Form SWU-102
2. Check for the processing fee in the amount of $420.00
3. Two (2) sets of Plans, Sheets C1.02 - Grading, Sheet CL04 - Details, and Sheet
C1.05 - Pond Details, dated June 30, 2006
4. Two (2) copies of Elizabeth City Quad Map showing the project location
5. Two (2) copies of pond calculations for surface area of pond, temporary and
permanent pool volume, and sizing of orifice
6. Two (2) copies of Drainage Narrative (3 pages)
On Tuesday, July 11, 2006, Ronnie Spivey of this office met with Josh Pelletier of the U.S.
Army Corp of Engineers at the site. Mr. Pelletier determined that there were NO jurisdictional
wetlands within the project area. Since this is a new requirement before a stormwater permit is
issued, we are not completely sure of what all you need from us regarding this determination. We
have requested that Mr. Pelletier provide us with a letter stating that no wetlands are involved. Mr.
Pelletier has been on vacation and was expected back in his office today. Once we receive this
letter, we will be glad to provide you with a copy if required.
This project is a Site Plan for constructing the new Albemarle District Jail building on Lot 7, Section
C, in the Pasquotank County Commerce Park. The disturbed area for this project is 14.3 acres,
which is generally the entire site, minus existing ditch slopes on the south and west property lines.
All drainage basins which contain impervious areas are designed to drain to a proposed wet detention
pond on the southwest corner of the property.

Mr. William J. Moore
July 24, 2006
Page -2-
The site improvements include a perimeter road, with roadside swales / ditches, that drain
to the pond. To check for any excessive, erosive velocities in any of the roadside ditches, l selected
(lie largest basin area (with the most impervious area), and calculated the velocity (fps).
The proposed roadside ditch upstream of the x-drain located under the gravel road, next to
the pond, has an upstream drainage area of 2.24 acres.
The velocity in this ditch at the x-drain location is approximately 1.9 fps, which is less than
the allowable 3.0 fps for a silt -loam type soil, in an unprotected channel. (See attached calculations)
This site has a proposed access road that will be named "Executive Drive South". This
access has not been constructed. Pasquotank County has had discussions with the location NCDOT
office about them installing this access road, which is approximately 2,600 LF in length. It is now
evident that the street will not be installed soon enough to accommodate the anticipated beginning
construction date, which is scheduled for this fall. Due to the schedule as noted above, Pasquotank
County has obtained an agreement with Mr. Bateman, the adjoining land owner, who owns the
property to the North (60' right of way) and south of the proposed Jail site. Mr. Bateman has an
existing gravel roadbed, which he uses to access his farm land, and he has agreed to let Pasquotank
County use his gravel road for construction vehicles doing site work on the new jail, providing they
repair the road, should that be necessary. The County would be using approximately 1,800 LF of
the existing gravel road, which follows the western boundary of Section C, to Commerce Drive (SR
1464).
Please let me know if you should need any additional information in order to complete your
review.
Sincerely,
r � a- 13u,,;,
Dori A. Bunch
Engineering Technician
DAB/rae
Enclosures
CC: Mr. Rodney Bunch, Assistant County Manager (w/ enclosures)
Mr. Randy Cartwright, Sheriff (w/ enclosures)
Mr. James Ruckman Architect (w/ enclosures)

STATE OF NORTH CAROLINA
:PARTMENT OF NATURAL RESOURCES
AND COMMUNITY DEVELOPMENT
RAL.EIGH, NORTH ff - 'A
"'. " Ng,c. BYPsss SUNBURY 3r KM
!SOUTH MCO VS CORNER 6.8 KM
e
EC Bypass
Commerce Dr.
a4
Lot 7, Section C
Proposed Albemarle
District Jail
iI
4
Scal : 1 11 = 2000'
2000' 100 ' 0' 200 '
AUG 2'3 2006
NORiH
DWQ-WARD
17`3W 2600000 FEET 395 396
II µ'Gem ►^`=fJ Pasquotank River
iss °•� ='`� ! ` '(Class WS III Sw)
• J k
1 BM3.6
Ct
3 •° / y ��
1 i
0
1339 � o
Pasquotank County
Commerce Park Ch 3.a
(Sections A, B, & C)
2.0
A\
F -- Knobbs Creek
_¢:z (Class C Sw)
�4 F
7.5 Minute Series Quad
covering area of
Pasquotank County
"Commerce Park"
Plot Scale: 1" = 2000' - Plot Date: 7-06-2006
Ad WDOWELL & ASSOCIATES, P.A.
ENGINEERS • SURVEYORS
P. 0. BOX 391
1715 VVEEKSVILLE RD.
ELIZABETH CITY, NORTH CAROLINA
[phone] FAX [phone]

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
July 31, 2006
Pasquotank County
Attn: Randall W. Cartwright, Sheriff
Box 587
Elizabeth City, NC 27909
SUBJECT: Stormwater Application
Proposed Albemarle District Jail
Dear Mr. Cartwright:
Alan W. Klimek, P.L. Director
Division of Water Quality
This office received a stormwater permit application for the subject project on July 26, 2006. A
preliminary review of your project indicates that the application package is incomplete. The following
items are needed to make the package complete:
_ $420 check
signature by owner on page 4 of application
2 sets of plans
narrative
supplement (wet detention, infiltration basin,
system, underground infiltration trench)
signature by owner on supplement form
-Zsoils report
low density, curb outlet system, off -site
We are returning the entire package to you. Once the package is complete you may resubmit.
You should also be aware that the Stormwater Rules require that a permit be issued prior to any
development activity. Construction without a permit is a violation of 15A NCAC 2h.1000 and North
Carolina General Statute 143-215.1 and may result in civil penalties of up to $10,000 per day.
If you have any questions, please feel free to contact any of the coastal stormwater staff here in
the Division of Water Quality at 252-946-6481.
Si cerely,
Al Hodge, Regio �Dpervisor
Surface Water Protection
Washington Regional Office
Enclosures
cc: Don Bunch, McDowell & Associates, PA
WaRO
North Carolina Division of Water Quality Internet: www.newaterqualiDy.ora One
943 Washington Square Mall Phone [phone] NorthCarolina
Washington, NC 27889 Fax [phone] NratuyallY
An Equal Opportunity/Affirmative Action Employer — 50% Recycledl40% Post Consumer Paper ii li LLL

r1r;'i �r.
7 r�
AUG 2; 3 2006
Drainage Narrative
By McDowell & Associates WARO
PO Box 391
Elizabeth City, NC 27909
Ph [phone]
Date: June 30, 2006
Project: Proposed Albemarle District Jail to be located on Lot 7,
Section "C", Pasquotank County Commerce Park
Owner: Pasquotank County
Property Size: 15.00 Acres
Zoned: 1-1 (Industrial)
A. Existing Site Description:
4 2006
Q-WARO
Lot 7, Section "C", is a portion of "Pasquotank County Commerce Park", an industrial park north
of Elizabeth City, located just off the south side of U.S. Rt. 17. The new Elizabeth City Bypass is on the
West side of this industrial park.
Section "A" (Phase 1) has already been subdivided, platted, and most of the lots have been sold.
Section "A" was submitted to the Department of Natural Resources (Stormwater) in 1999, as a "Low
Density" project.
Section ."B" has been subdivided & platted. Section "B" is currently awaiting the installation of
drainage and sewer improvements. This section was submitted to the Department of Natural Resources
(Stormwater) in 2005, as a "Low Density' project.
Section "C", is in the process of being subdivided. Section "C", as was the rest of this park
property, was previously under cultivation with row crops. The land elevation of Section C is generally
around 14.0 MSL, with existing field ditches that drain almost due south, into a system of larger ditches,
and finally into a tributary of the Pasquotank River.
Adjacent Properties: "Pasquotank County Commerce Park" is bordered on the west side by Rte.
17 Bypass, on the north by the old Rte. 17 Bypass, on the east by residential, and on the south by
residential 1 farming.
B. Proposed Development I Impervious Areas:
Lot 7, Section "C", which has a total lot area of 15.00 Acres, will be the site of the Proposed
Albemarle District Jail. The new jail building will be situated slightly north of the center of the property,
and surrounded by a network of roadways, most asphalt, some will be gravel.
The finished floor of the building is set at elevation 15.50 MSL, to provide positive drainage away
from the building, into the proposed ditch 1 storm drain system.
The proposed roadside ditches will be typical "V" type, and are designed with a drainage slope of
0.20%, and the side slopes will be 4:1.
The percentage of proposed impervious area necessitates the installation of a proposed wet
detention pond, which is located on the Southwest corner of the property.

Proposed Impervious Area is calculated as follows:
Asphalt Streets, Gravel Streets, Roof, concrete, and Future Tower 4.99 Ac
Future Bldg. on South end of site (shape not known) 0.50 Ac
5.50 Ac
Total Impervious
Calculate % of Impervious:
5.50 Ac Impery = 47% Impery (use 50% imperv. for sizing pond)
11.64 Ac (area that flows into Pond — see below)
Areas contributing runoff into Pond:
East & West Basins = 3.53 Ac + 4.69 Ac = 8.22 Ac
Roof Area of Bldg 1.19 Ac
El Basin (thru Pond but not thru upstream culverts 1.64 Ac
Perimeter Area of Pond (not water surface) 0.60 Ac
11.64 Ac Total into Pond
Note: 15.00 — 11.64 = 3.36 Ac that does not drain into the pond
(includes the perimeter of site (easements 1 setbacks), and the pond water surface)
Note: None of the 3.36 Ac that does not drain into the pond have impervious areas
C.) Storm water Treatment 1 Erosion Control Devices:
Storm water runoff from this project will be treated by the use of a wet detention pond, which is
described in detail later in this narrative.
Storm water runoff from the building roof area will be collected, and travel thru a collection system
of various diameters, into the proposed storm drain system.
Runoff from the yard and asphalt parking will be transported through vegetated swales, into the
proposed storm drain system, and finally to the proposed wet detention pond.
Ditches are designed to be constructed with side slopes no steeper than 4:1, as detailed on the
Site Plan, and will be protected by proposed rip -rap filter dams installed prior to their release of runoff
into an offsite ditch.
All drop inlets will be protected by sediment traps during the construction period.
The proposed wet detention pond is designed for 50% impervious area (see above), with a
permanent pool depth of 6 feet, and without an onsite vegetative filter. The pond as designed should
remove 90% of TSS. The pond has a 10' shelf around the perimeter. The pond will have 2 inlets (fore
bays), which are sized to provide 20% of the total pond volume.
The pond will be used as a sediment pit during the construction period.

r
Calculate Pond Storage:
A.) Required Storage (based on 1" — no "C" factor) 11.70 Ac (43560) (0.08333') = 42,469 Cu Ft.
B.) Required Storage (based on using 0.74 as weighted "C" factor) 0.74% of 1" 112 = 0.06167'
11.70 Ac (43560) (0.06167') = 31,430 Cu Ft.
C.) Provided Storage in Pond, as currently designed 47,039 Cu Ft
Provided Storage in Ditches 1 Pipes to elev 12.00: 10,984 Cu Ft
Total Provided Storage: 58,023 Cu Ft
Summary: The temporary pool of the Wet Detention Pond as designed will store the required
volume in approx. 12" of its designed height of 18".
3

RECEIVED L!
SA-DA Tables Stormwater.xIs
Date:June 30, 2006
Project: Albemarle District Jail
McA Proj. #: E1685
A.) Determine Required Pond Water Surface Area (SAIDA):
AUG 2 3 2006 AUG 2000
SAIDA Values listed below are from "Coastal" Chart, with no vegetative filter,
For Permanent Pool depth of 6', Total Suspended Solids (TSS) Removal = 90%
11.7 Ac contributes Drainaae to Pond (Lot 7 = 15.00 Ac)
% Imperv.
SAIDA Value
Contributing Basin Ac
Water Surface Ac.
30
1.6
11.7
0.187
40
2.1
11.7
0.246
50
27
11.7
0.316
60
3.4
11.7
0.398
70
3.9
1 11.7
0.456
Note Al: ADJ impervious = 47% actual (use 50% for Design)
Note A2: Required Water Service = 0.316 Ac (Provided = 0.66 Ac.)
B.) Required "Temporary Pool" Storage Volume (Above Permanent Pool):
Pond to be designed to hold the volume equivalent to 1" of rainfall on the entire Drainage Basin:
(Note: no allowance to be made for type of surface, "c" factor, etc. - simply 1" over site)
Calculate B, Above:
Contrib. Area Ac
Cu Ft of storage 1"
Acre Ft of Storage
11.70
42469 -
0.98
(Minimum)
Note B1: See Drainage Narritive for Additional information on Provided Storage Volume
C.) Provided "Temporary Pool" Storage Volume:
Location
Elevation
Area in Sq Ft.
Volume (Cu Ft)
Volume (Cu Yd.
Top Temp. Pool
12.00
33,881
Bottom Temp. Pool
10.50
28,837
47,039
1742
1.bu
(Temp. Pool Depth )
"Temporary Storage" Required = 42469 CF (Minimum)
Provided = 47039 CF
Note Cl: See Drainage Narritive for Additional information on Provided Storage Volume
Page 1 of 3

J
D.) "Permanent Pool" Volume Calculations - These include Forebay:
Location
Location - Elev.
Area in Sq Ft.
Volume Cu Ft)
Volume Cu Yd.
Top Perm. Pool
10.50
28,837
Bottom of shelf
9.50
21,036
24937
924
Bottom of Forebay,
6.50
13,645
52022
1927
& Main Pond
Main pond Only
6.50
12,746
Bottom Main pond
4.50
9,081
21827
$9$
98785 3659
E.) "Forebay" Permanent Pool Volume Calculations:
Location
Location - Elev.
Area in Sq Ft.
Volume (Cu Ft)
Volume Cu Yd.
Top Perm. Pool
10.50
9,060
Bottom of shelf
9.50
5,366
7213
267
Bottom of Forebay
6.50
1724
10635
34
17848 1 661
Forebay / Main Pond % = 17848 1 18% 1 Goal = 20%
98785 OK - Pond Oversized)
Page 2 of 3

1
ADJ Pond Orifice.As
Date: June 7, 2006
Project: Albemarle District Jail, Lot 7, Pasquotank County Commerce Park
McA Proj. # E1685
Determine the Orifice Size (Diameter) for Controlling the Detention Time of the
"Temporary Pool"
F.) Calculate Orifice Size for Outlet Structure:
Volume Calc
Detention Time for Orifice (4")
Pond Elev
Area (Sq Ft
Volume Cu Ft
Feet of Head
**CFS
"Velocity
Flow Time Min
(Avg.)
12.00
35,072
17,099
1.25
0.40 ' =
4.60
712
11.50
33,325
161234
0.75'
0.31- .
3,50
873
11.00
31,611
15,386 =
0.25
0.17
2600
1508 .
10.50
29,931
Total Min 3094
Total Days 2.15
OK - Regulations = 2-5 Days
** Flow (CFS) thru Orifice sized as shown & Velocity calulated by "TR-55" Software for
a Borda" type orifice - 0.51 C.
Page 3 of 3

Date: June 07, 2006 JUL 13 2006
Project: Proposed Albemarle District Jail - on Lot 7, Section C, DWQ-WARD
Pasquotank County Commerce Park
Check velocity (fps) in proposed roadside ditch at xdrain location
under gravel road, next to pond. Upstream drainage basin area = 2.24 Ac
(this basin area represents the largest land area (with the most impervious area),
which empties into a proposed roadside channel.
Determine the Q10 flow: (by Rational method)
2.24 Ac (0.72 weighted "C") (3.9" rainfall based on Tc 26.7 min.) = 6.29 CFS
Channel Calculator
Given Input Data:
Shape ........................... Trapezoidal (Typical "V" type ditch w14:1 side slopes)
Solving for ..................... Depth of Flow
Flowrate ........................ 6.2900 cfs
Slope ........................... 0.0020 ft/ft
Manning's n ..................... 0.0200
Height .......................... 18.0000 in
Bottom width .................... 0.0000 in
Left slope ...................... 0.2500 ft/ft (VIH)
Right slope ..................... 0.2500 ft/ft (VIH)
Computed Results:
Depth ...........................
10.8614 in
Velocity ........................
1.9195 fps (permissible velocity for Site soils)
Full Flowrate ...................
24.1923 cfs
Flow area .......................
3.2770 ft2
Flow perimeter ..................
89.5657 in
Hydraulic radius ................
5.2686 in
Top width .......................
86.8915 in
Area ............................
9.0000 ft2
Perimeter .......................
148.4318 in
Percent full ....................
60.3413 %
Critical Information
Critical depth ..................
8.2513 in
Critical slope ..................
0.0087 ft/ft
Critical velocity ...............
3.3259 fps
Critical area ...................
1.8912 ft2
Critical perimeter ..............
68.0420 in
Critical hydraulic radius .......
4.0025 in
Critical top width .....1........
66.0104 in
Specific energy .................
0.9624 ft
Minimum energy .................. 1.0314 ft
Froude number ...................
0.5030
Flow condition ..................
Subcritical
DECEoWC
JUL 12 2006
LAND QUALITY SECTION
WASHINGTON REGIONAL OFFICE

JUL 13 2006 FINANCIAL RESPONSIBILITY/OWNERSHIP F RM
SEDIMENTATION POLLUTION CONTROL ACT
No p�e�rson�-may initiate any land -disturbing activity on one or more acres as covered by the Act before this
form and an acceptable erosion and sedimentation control plan have been completed and approved by the
Land Quality Section, N-C. Department of Environment and Natural Resources. (Please type or print and, if
the question is not applicable or the e-mail and/or fax information unavailable, place NIA in the blank.)
Part A. frp.�s
1. Project Name: Proposed Albemarle District Jail
2. Location of land -disturbing activity: County: Pasquotank City or Township: Providence Township
Highway/Street: SR 1464 (Commerce Drive) Latitude
Longitude
3. Approximate date land -disturbing activity will commence: Fall 2006
4. Purpose of development (residential, commercial, industrial, institutional, etc.): Albemarle District Jail
5. Total acreage disturbed or uncovered (including off -site borrow and waste areas): 14.3 acres
6. Amount of fee enclosed: $750.00, The application fee of $50.00 per acre (rounded up to the next acre)
is assessed without a ceiling amount (Example: a 9-acre application fee is $450).
7. Has an erosion and sediment control plan been filed? Yes No Enclosed_XXX_
8. Person to contact should erosion and sediment control issues arise during land -disturbing activity:
Name: Don Bunch E-mail Address: [e-mail]
Telephone: [phone] Cell #
Fax: [phone]
9. Landowner(s) of Record (attach accompanied page to list additional owners):
Pasquotank County 252-335-5177
Name Telephone
P. O. Box 38 206 East Main Street
Current Mailing Address Current Street Address
Elizabeth City NC 27909 Elizabeth City NC
City State Zip City State
10. Deed Book No. 514 Page No. 486 Provide a copy of the most current deed.
Part B.
rfD 12 � -
JUL 1 2 2006ED
LAND 9UALITAkTION
WASHINGTON REGIONAL OFFICE
1. Person(s) or firm(s) who are financially responsible for the land -disturbing activity (Provide a
comprehensive list of all responsible parties on an attached sheet):
Pasquotank County
Name
P. O. Box 39
Current Mailing Address
Elizabeth City
City
E-mail Address
206 East Main Street
Current Street Address
NC 27909 Elizabeth City
State Zip City
NC 27909
State Zip
Telephone: [phone] Fax Number: 252-337-6733

.
2. (a) If the Financially Responsible Party is not a resident of North Carolina, give name and street address
of the designated North Carolina Agent: N/A
Name
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip City State Zip
Telephone
Fax Number
3. (b) If the Financially Responsible Party is a Partnership or other person engaging in business under an
assumed name, attach a copy of the
Certificate of Assumed Name. If the Financially Responsible
Party is a Corporation, give name and street address of the Registered Agent: NIA
Name of Registered Agent
E-mail Address
Current Mailing Address
Current Street Address
City State
Zip City State Zip
Telephone
Fax Number
The above information is true and correct to the best of my knowledge and belief and was provided
by me under oath (This form must be signed by the Financially Responsible Person if an individual
or his attorney -in -fact, or if not an individual, by an officer, director, partner, or registered agent with
the authority to execute instruments for the Financially Responsible Person). I agree to provide
corrected information should there by any change in the information provided herein.
Randall W. Cartwright
Type or print name
ignature
-----------------------------------
M
Sheriff
Title or Authority
July, 2006
Date
a Notary Public of the County of
State of North Carolina, here -by certify that Randall W. Cartwright appeared personally before me
this day and being duly sworn acknowledged that the above form was executed by him.
Witness my hand and notarial seal, this 1�
Seal
day of July, 2006
Notary
My commission expires