Mahire, Phillip

❑ 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.
PE: :rIIT P: 30 -41 j ,T1
9 MAINTENANCE AND REPRtRWILMINIGGTOON, NC
Address,, iy[X,Pdi�/w
city ei d vv 11,// W-e,
Phone # (qfi) 606 03c9b
Authorized Agent
Type of Project
Notes or special
conditions:
Permit # JUN 15 2005
Date previous
permit issued
Project Location Information pp
Street Address ci'3� ( t44dA6 le
Adj. Water Body
AEC ❑ CS P,6E ❑ HH ❑ IH
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2,4,.r g:o�
Name (Print) P Signature
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Signature (owner or agent) Issu ce date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024