Special Permit Application

(In Termsof Section 14(3) of Coast Conservation & Coastal Resource Management Act No. 57 of 1981)

Applicant Name*

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NIC*

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Address*

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Telephone

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Mobile*

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Email*

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Fax

Location(Address)*

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Province*

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District*

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District Secretariat Office*

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Local Authority*

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GN Office *

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Event Details

Purpose of the Usage*

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Time Starts*

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Time Ends*

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Purpose of the Event*

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Any Other Details

Payment Method*

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