Crumley, Dave

'14W4 Is 6 V-V 6 •
PE: .WZT P: .OGR'.W
❑ MODIFICATION ❑ EXEMPTION
Town of Oak Island
CAMA Minor Permit Office
As authorized by the State of North Carolina
per the Coastal Area Management Ad of 1974
Applicant
Address /,�% ��/• � f%�
City C�/j� �� �/n✓Q
Phone # (��) 21 �4
Authorized Agent k&/V /����G��i-"%L
Type of Project
Description of Activity:
Notes or special
conditions:
JOwwn7's/NName (Punt)
Signature (owner or agent)
V,AAAINTEN{� E„A�ICj�2E'v
AIR
Permit # I 11Lk1�" ((l�/�
Date previouf
permit issue{
L� DIVli
COARTAI
Project Location Information
Street Address /3O? 4/ !
Adj. Water Body , -
AEC ❑ CS B OE ❑ HH ❑ IH
LPO Signature
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024