13915_POTOCKO, WILLIAM_19950214

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PERMIT A
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name K V I
Address 2 2.
City /? "� ' 4.
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
CAMA AND DREDGE AND FILL
GENERAL
State
Phone Number
Zip
PROJECT•
Pier (dock) length
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
applicant's signature
permit officer's signature
issuing date expiration date
attachments � 14 r �
application fee—°

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S. E. TURNER MARINE CONSTRUCTION
CHARLES R. WEBB OWNER
P. O. BOX 1885 PH. 919-726-1253
MOREHEAD CITY, NC 28557
PAY
p TO THE
ORDER OF
4203
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—DOLLARS
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Athmtic Beach, I
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR ""�Rr
I hereby certify that I own property adjacent to f,` ? ; , c i 's
property located at Ki r I f t f-1
(lot, block, road, etc.)
on ,— A
(water body)
in A, i . ( h �:l , , N.C.
(town and/or county)
He has described to me as shown below the development he is proposing at that location
and I have no objections to his proposal. I understand that a pier must be set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
I do do not wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: (to be filled in by individual
proposing development)
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Signat re
Name
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Phone Number r
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A -PIER)
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I hereby certify that I own property adjacent to PC 1 0 . K 0 's
property located at
(lot, block, road, etc.)
on C iv A L in A—C. A C ►A , Ca , N.C.
(water body) (town and/or county)
He has described to me as shown below the development he is proposing at that location
and I have no objections to his proposal. I understand that a pier must be set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
do \ do not wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposgddevelopment:
proposing development) C P
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�L'�eW iN
0( L-o-T-
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(to be filled in by individual
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rUr- m CcU6-1H AN
Name
Phone Number
rA t.1 . i o , t q C't 5

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