GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS --------0-------- DEPARTMENT OF PLANNING AND NATURAL RESOURCES Coastal Zone Management Program CHARLES WESLEY TURNBULL REGIONAL PUBLIC LIBRARY 4607 TUTU PARK MALL ST. THOMAS, VI 00802 TEL: (340) 774-3320 FAX: (340) 714-9524 DEPARTMENT OF PLANNING AND NATURAL RESOURCES St. Thomas, Virgin Islands CZM Permit No: _________________ Date: ___________________ Tel: ___________________ Request is hereby made for the Issuance of a “Certificate of Completion” for the following property. Location _____________________________________ Owner ____________________________ Mailing Address: _________________________________________________________________ DESCRIPTION ( ) First Floor ( ) Second Floor ( ) Entire Building Scope of work completed:__________________________________________________________ ______________________________________________________________________________ Contractor: ______________________________________________________________________ The construction work has been done under the supervision of: Owner _____________________________ Date: ____________ Engineer/ Architect ___________________ Contractor __________________ Date: ____________ --------------------------------------------------------------------------------------------------------------------------- FOR DEPARTMENT USE ONLY The work authorized by the above listed complies with the Virgin Islands Coastal Management Act and the provisions of the Coastal Zone Permit issued pursuant thereto. Inspected by: ______________________ Date: _______________ _____________________ ____________ Approved Denied Director, CZM Date