Bolding, William

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❑ 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 Name;\ \ % P�00i
Phone #
Authorized Agent
Type of Project
Description of Activity:
Notes or special
conditions:
Owner's Name (Print)
Signature (owner or agent)
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/M/AINTENANCE i4ts,
Permit # IY
Date previous MAY
permit issued B inr,
COgS7g11 A . /.ON n,
Project Location Information ENT
Street Address L")
Adj. Water Body
AEC ❑ CS VOE ❑ HH ❑ IH
,LPO Signature
Z/ / /-- -) �:- 12- _ /-os
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024