Canning, Harold

:.-.?Ig ?ZIN 30: : p:
❑ 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 �A c> CAr..tr , N5
Address ,Cr) (')Cf-a.., i r.r4
CityC�r islr"ao
Phone # (Cilo) a7g • 5G uu
Authorized Agent
Type of Project
Description of Activity:
CEAY -
Notes or special
conditions:
4ner's
Name (Print)
Signature (owne i r agent)
?IIT P: 304113w:
❑ MAINTENANCE AND REPAIR Z
Permit # 2 L
Date previous a°
permit issued o 2
s
_2
Project Location Information
Street Address 56l/=0 Oc,�a , a.
Adj. Water Body L6 t
AEC ❑ CS ❑ OE ❑ HH ❑ IH
LPO Signature
S-, 2-q, 6 S /Z - 3 /' 05-
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024