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Important — A public hearing MUST be conducted whether or not requested by the Public. <br />ROAP PUBLIC HEARING RECORD <br />Date Public Notice was published: <br />APPLICANT: <br />DATE: <br />PLACE: <br />TIME: <br />How many ; :OMMISSIONERS attended the public hearing? <br />How many members of the PUBLIC attended the public hearing? <br />Public Attendance Surveys <br />❑ (Attached) <br />❑ (Offered at Public Hearing but none completed) <br />I, the undersigned, representing (Legal Name of Applicant) do hereby certify to the North <br />Carolina Department of Transportation, that a Public Hearing was held as indicated above and <br />During the Public Hearing <br />❑ (NO public comments) <br />❑ (Public Comments were made and meeting minutes <br />will be submitted after board approval) <br />The estimated date for board approval of meeting minutes is: <br />Signature of Clerk to the Board <br />Printed Name and Title <br />Date <br />Affix County Seal Here <br />Attachment number 5 <br />G -1 Page 101 <br />