GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS



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DEPARTMENT OF PLANNING AND NATURAL RESOURCES

Division of Coastal Zone Management



No. 45 Estate Mars Hill, Frederiksted $100 Lindberg Bay, Ste #61, C.E.K. Airport

St. Croix, US Virgin Islands 00840-4477 St. Thomas, US Virgin Islands 00802

Tel: (340) 773-1082; Fax: (340) 773-3343 Tel: (340) 774-3320; Fax: (340) 714-9524



APPLICATION FOR MODIFICATION OF PERMIT



Pursuant to Title 12 Chapter 21 of the Virgin Islands Code and the Coastal Zone Management Rules and



Regulations, 12, V.ILR.R. §910-14, the following request for Modification of (check one) [¥] Minor [Major

Permit No. €Z1-47-63w is hereby submitted.



1. Name, mailing address, email address and telephone number of Applicant/Permittee CROWN BAY MARINA, L.P.



8168 CROWN BAY MARINA, STE. 528, ST. THOMAS, VI 00802. 340-774-2255



2. Name, mailing address, email address and telephone number of the Property Owner KOSEI OHNO

8168 CROWN BAY MARINA, STE. 528, ST. THOMAS, VI 00802. 425-5058873



3. Location of activity. PlotNo. 168 & 169 Estate SUBBASE Island ST. THOMAS



4. Summary of proposed activity. Include all incidental improvements such as utilities, roads, etc. (Use additional

sheets if necessary). INSTALL CONCRETE PIER BASE FOR SAIL SHADE POST, REMOVEABLE TENTS & FAUX FACADE, PINIC TABLES & CHAIRS.



INSTALL PREFAB, RESTROOMS ON CONCRETE SLAB, MOVEABLE KIOSK AND/OR MOBILE BAR, EXTEND EXISTING SEWER LINE TO MODILE

KITCHEN & RESTROOMS



5. Please attach the Application Fee or Receipt: $50.00 for Minor Permit; $500.00 for Major Permit. In addition,

please provide the following required documents:



a) Tax Clearance Letter from the Bureau of Internal Revenue



b) Property Tax Clearance Letter from the Office of the Lt. Governor



c) Corporations and Associations: Certificate of Good Standing or equivalent

d) Required or pee crowing: showing proposed activi



e) EH oer ®. port (if applicable).

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‘Date ig of Owner Date



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Inspector Date



APPLICATION: APPROVEDO DENIEDO



Commissioner Date