Rogers, Julian

=,-XYi. rIIN 30: APO'
❑ 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 Nam�r4
Address20/ C LIeAc,C UK
CityCSici1Arim! iJC.
Phone # (9/o ) 36 7 (S/ )
Authorized Agent
Type of Project
Description of
of Activity:
20n"�r1 sf.4, rac)'-
Notes or special
conditions:
s
(owner or agent)
:r t=T P: 30
I5-MAINTENANCE AND
Permit #_
Date previous
permit issued_
Project Location Information
Street Address ;oi E %TPzgc,C
nQ r3A6(1rlALL Y"L
Adj. Water Body Qce4,J
AEC ❑ CS C-OE ❑ HH ❑ IH
L 0 Signature
�i'•1Z•65 /,?•3/dS
Issuance date exp. Date
Oak Island Development Services — 518 Yaupon Drive — Oak Island NC 28465 — 910-278-5024