Tyson, Frank

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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 Act of 1974
Applicant Name )G?Agt6 7l
City je i A-yL-77'E /I/ G
Phone # (22V ) :; 4 4 -- S9 Z
Authorized Agent
Type of Project
Description of Activity
Notes or special
conditions:
-7K. 0,70 q
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Owner's Name (Print)
Signature -(owner or agent)
MAINTENANCE AND REPAIR Permit # H Vp
E
Date previous
permit issued Im
MAR 2005
DIVISION OF
Project Location Information
Street Address 35 it F R.9., S7
Adj. Water Body
AEC ❑ CS ❑ OE ❑ HH ❑ IH
LP Signature
-7-9'- oS 6 -30 -oS
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024