GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES

GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES -o--- DEPARTMENT OF PLANNING AND NATURAL RESOURCES Division of Coastal Zone Management Cyril E. King Airport Terminal Building Second Floor St. Thomas, Virgin Islands 00802 Fax: Tel: REQUEST FOR AMENDMENT /MODIFICATION TO MINOR COASTAL ZONE PERMITS No. Cif-- 2-6- - 161-- This request is pursuant to Chapter 21, 'Rile 12 of the Virgin Islands Code and the Coastal Zone Management Rules and Regulations. 1. Name, Mailing address and telephone number of applicant. • S •T, clo 4 /en) le-ci dvdt doeveier, fi t. i 2. Name, title, mailing address and telephone number of the owner of the property. 5Wer"t A- Late. St- Is Li 3. Location of activity. Plot No. 0 Estate-- Island 4. Summary of proposed activity. Include all incidental improvements such as utilities, roads,etc. (Use additional sheet if necessary). Tee_ ocarviazie This modification if approved is subject to the conditions of Permit No. that are not superseded by this modification. Signature of applicant Date Signature of Property Owner Date The Commissioner reviewed the requested amendment / modification and determined that it will /will not significantly modify the scope, nature or characteristics of the proposed development. Inspector Date Application Approved ( ) Commissioner Date Application Disapproved ( ) EFTA01105410