68589D - Oak

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ±PAK Y K s
(Name of Property Owner)
property located at
(Address, Lot, Bloch, Road, etc.)
on �i� �,�� in A, 'K -r �' N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development -
I , I have no objection to this proposal.
I have objections to this proposal.
sed at the above local
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawini
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set b
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
(Ad;acent Property Owner Information)
Signature
Print or Type Name
Print or Type Name

JWW Approx . 415' wide
Grass to Grass
AIWW
Ni
----------- I ---------------------------- F-------------------------------------------------------
415'
15' '
itephen Kunkel
308 E. Yacht Dr.
;
/ +100' to Federal Channel Setback
4' water depth @ MLW
161' 10'x4' 240'
U1 ,
6'x
Edge Of Marsh
Marsh
406' ;

AIWW Approx . 4 15' wide
Grass to Grass
F'l
Ni
-------------- r--------------------------- t--------------------------------------------------------
/ +100'to Federal Channel Setback
4' wat¢r depth @ MLW
161' 2 0#
10'x40' '
415' ;
15' ; '
6'x70' 15' ;
Edge OfMar�sh�
' Marsh
Stephen Kunkel 406 ,
1308 E. Yacht Dr.
nnilnrnry tee-_

s plete Items 1, 2, and 3.
■°'Priitty�name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
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1. Article Addressed to:
Qo,r, , Ac, C1
A. Signature
X ' \ ❑ Agent
❑ Addressee
B. Received by (Print e) C. Datf of D ivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
a btype
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El Registered MaiITM
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9590 9402 2863 7069 5201 52
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2. Article Number (Transfer from servire lahan
❑ Collect nn nervery Restricted Delivery
El Signature ConfirmationTM
7 017 0 6 6 0 0000 9578
8543 ed Delivery
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
_or on the front if space permits.
1. Article Addressed to:
Kul, ke I
(e"c'V �tr�
�C4 �� \� C'\L l ✓)(.
A. Sign
❑ Agent
X�,
-
❑ Addressee
B. Re c ived by (Printed Name)
C. Datq of DDlivery
D. Is delivery address different from item 1?
❑ Yes
If YES, enter delivery address below:
❑ No
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E OultSig type
❑ Adult Signature
❑RegiteredM ilTmr' f
El Registered MaiIT;^
❑ Adult Signature Restricted Delivery
❑ Registered Mail,ttestricted
9590 9402 2863 7069 5201 45
❑ Certified Mail@
Certified Mail Restricted Delivery
�ivery
.i"?.lReturn Receipoor
°� ^ nl r tio, rr =^^f rrnm --iro rahafl
❑ Collect on Delivery 40.1" nndfae
❑ Collect on Delivery Restricted Delivery ❑ Signature Co tfirmationTM
7 017 0660 0000 9578 8567 Vlail Restricted Delivery
❑ R stnctedbelivery lion
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PS Form 3811, July 2015 PSN 7530-C2-000-9053
DomestiCTieturn Receipt
U.S. Postal ServiceTM
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
For delivery information, visit our website at www usps.com®.
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