Keesee, Brian

❑ 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 r la I-) tcLdtu
Address
City /611 n� rt �n
Phone # I'r0b �' !
i -
Authorized Agent V TV- r -
Type of Project
Description of Activity:
M�. IYt
Notes or special
conditions:
Owner's Name (Print)
ZIC,
Signature (owner or agont)
YXW P: OGRJ__,TZ
RECEIVED
AINTENANCE ANdDIW1gKMINGTON, NC
Permit# MAY o 5 2-005
Date previous
permit issued
Project Location Information / y�
Street Address
Adj. Water Body
AEC ❑ CS DOE ❑ HH ❑ IH
PO Signature
<-.!1•uS /ZLi e)S
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024

LOT 9RECEIVED
i-A
DCM WILMINGTON, NC
OT 10-A
I
sl TRIC
MAY 2 52005
LOT
9-A
X 4oU LOT
T
Pk
4,
6.93
C""Frame- to )5xgc &dv0cm
E'JS� k I k A ai add 10-hod tL 0-yeo- (plua�YJ ve4A
(fit Disc. ulY'e'-'d Plurvibir, 'e-lejj4rjc'cJ j
W Pool Ptkrn 041d eleCI-Vir (L
C15 mockcly�y. ' i-0 l ecJcd Ovea Yec(c(cf-I-m
YQ,ry\o,VCLI ut rczt)kr-)