Williams, George

30:
❑ 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
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�MAINTENANCEAND CEIVED
1 1v1 WILMINGTON, NC
Permit #
Date previous 5 2005
permit issued
Applicant Name PO/cif
Address /0%3 S.
city 9A11n ogJo
Phone # (33LV-1.3—Sc20I2' L
Authorized Agent
Project Location Information
Street Address 2oogpVU. pri(nuh
Cyr F 754c7 /v- C, 2
Adj. Water Body A/,Ga � <
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Type of Projectse
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Notes or special I■MOMMMMMMMMI MMMOMINOMI■
conditions: 6
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Owner's Name (print)
Signature (owner or agent)
LPO Signature
.S- /I Q S /2.3/ o S
Issuance date
exp. Date
Oak Island Development Services - 518 Yaupon Drive - Oak Island NC 28465 - 910-278-5024