TOWN OF EMERALD ISLE
			7500 EMERALD DRIVE
			EMERALD ISLE, NC 28594
		APPLICATION FOR BEACH DRIVING PERMIT
						PERMIT #___________________
(Please print or type)
Name	_______________________________________________________________________
Mailing address___________________________________________________________________
	___________________________________________________________________
Make of Vehicle  ___________________________________________						Year___________________
License Tag Number ______________________________ State_________________________
Drivers License Number____________________________ State Issued___________________
Date of Birth_____________________________________
Emerald Isle Resident/Property Owner, Yearly Renter      Yes          No     (circle one)
______________________________________________________________________________
Emerald Isle Property Address
The applicant has been provided a copy of the Beach and Shore Regulations
pertaining to beach driving regulations.
By signing the application below, the applicant agrees to abide by the
rules and regulations governing beach driving and he/she will respect the
wildlife on the beach, and he/she is solely liable for any harm to endangered,
threatened, or protected species, and is solely liable for any and all penalties
associated therewith.
Signature________________________________________________ Date___________________