Yountz, Howard E.

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❑ MODIFICATION ❑ EXEMPTION
Town of Oak Island
CAMA Minor Permit Office
As authorized by the State of North Carolina
per the Coastal Area Management Ad of 1974
Applicant
Address lv ,
City 0, //-
Phone # (fih 1 51Y4 - Z z2 Y
Authorized Agent
Type of Project
DAscrription of Activity:
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Notes or special
conditions:
Owner's Name (Print)
Signature (owner or agent)
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WMAINTENANCE AND REPAIR
Permit# in) VJid
Date previous
permit issued MAR 10 11
005 D
DIVISION nF-
Project Location In ormatlon LVIIAINENT
Sttrr�eet Addresso M 2 A,, i3rcc4-
Adj. Water Body ©L± ecs -,L-
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CPO Signature
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Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024