Cole, Thurman

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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 NamZZ/YgM *�L n 6
Address 3 �ao Gl e-CiCZ
City, .-� S1i9/'yc/ ljC
Phone # (2iO 54�-Z3 7Z 6 3
Authorized Agent_ -/3
Type of Project
Notes or special
conditions:
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Owner's Name (Print)
Si nature (owner or agent)
61. AINTENANCE AN"EPAIR V I
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Permit # +
Date previous MAR 1 3 2G05
permit issued
DIVISION OF
COASTAL MANAGEMENT
Project Location Information
Street Address35a d
Adj. Water Body_ 4A , L-c
AEC ❑ CS B'6E ❑ HH ❑ IH
O 8ignature
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Issuance date exp. Date
Oak Island Development Services - 518 Yaupon Drive - Oak Island NC 28465 - 910-278-5024