Martin, Connie (2)

❑ 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 (rv� r�k // /rxr-)
Address o2Vo E )Z.wJ`L
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Authorized Agent Geary �(�� L4n:
Type of Project
Description of Activity:
Notes or special
conditions:
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Owner's Name (Print
Signature (owner or agent)
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Permit
Date previous Mq
permit issued
Project Location Information
Street Address =�9/o F_ f—"WW
Adj. Water Body AEC ❑ CS V // E ❑ HH ❑ IH
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Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island INC 28465 — 910-278-5024