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12 <br /> Important—A public hearing MUST be conducted whether or not requested by the Public <br /> PUBLIC HEARING RECORD <br /> Section 5311 (including ADTAP), 5310, 5339, 5307 and applicable State funding, or combination thereof. <br /> APPLICANT: <br /> DATE: <br /> PLACE: <br /> TIME: <br /> How many BOARD MEMBERS 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 /> ................................................................................................, <br /> Affix Seal Here <br /> Signature or Clerk to the Board <br /> Printed Name and Title <br /> Date <br /> ................................................................................................: <br />