GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS
GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS -----0------ DEPARTMENT OF PLANNING AND NATURAL RESOURCES Division of Coastal Zone Management No. 45 Estate Mars Hill, Frederiksted Charles Wesley Turnbull Regional Public Library St. Croix, VI 00840-4477 4607 Tutu Park Mall, St. Thomas, VI 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.I.R.R. §910-14, the following request for Modification of (check one) □ Minor □ Major Permit No. is hereby submitted. 1. Name, mailing address, email address and telephone number of Applicant/Permittee 2. Name, mailing address, email address and telephone number of the Property Owner 3. Location of activity. Plot No. Estate Island 4. Summary of proposed activity. Include all incidental improvements such as utilities, roads, etc. (Use additional sheets if necessary). 5. …
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GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS -----0------ DEPARTMENT OF PLANNING AND NATURAL RESOURCES Division of Coastal Zone Management No. 45 Estate Mars Hill, Frederiksted Charles Wesley Turnbull Regional Public Library St. Croix, VI 00840-4477 4607 Tutu Park Mall, St. Thomas, VI 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.I.R.R. §910-14, the following request for Modification of (check one) □ Minor □ Major Permit No. is hereby submitted. 1. Name, mailing address, email address and telephone number of Applicant/Permittee 2. Name, mailing address, email address and telephone number of the Property Owner 3. Location of activity. Plot No. Estate Island 4. Summary of proposed activity. Include all incidental improvements such as utilities, roads, etc. (Use additional sheets if necessary). 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 necessary drawings showing proposed activity e) Environmental Assessment Report (if applicable). Signature of Applicant Date Signature of Owner Date Print Print Inspector Date Commissioner Date Pursuant to 12 V.I.R.R. §910-14 (a) the Commissioner has determined that the request DOES / DOES NOT substantially alter the scope, nature or characteristic of the existing permit or approved development. As such, you MAY / MAY NOT proceed with the modification request. SIGN SIGN