Pugh, William

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❑ MODIFICATION V6EMPTION
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% - �'•ir';-.': �;
Address vi; , .•,„ - , h
City
Phone # (z;.
Authorized Agent
Type of Project
Description of Activity:
Notes or special
conditions:
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Owner's Name (Print)
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Signature (owner or agent)
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❑ MAINTENANCE AND REP
Permit #
Date previous
permit issued 'tiJ
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Project Location
Street Address i' % % / =lac z, ?ir
Adj. Water Body.
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LPOISignature
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Issuance date exp. Date
Oak Island Development Services - 518 Yaupon Drive - Oak Island NC 28465 - 910-278-5024

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Existing
Storage
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