26954_TIERNEY, ART_20001003

1
Your project is subject to the NC Division
CAMA and DREDGE AND FILL of Water Quality Neuse River Buffer Rules G E N E R A L {�
due to its location within the Neuse Basin. 6 9
please contact Deborah Sawyer at - me:_S �.:�":�
P E R M I T 252-946-6481.
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number
Address
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length f
.i
t _
!
��
"
, `-
7
i
(SCALE:
)
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j
i (
t
_ I
I
Groin Length
number
Bulkhead Length
max. distance offshore
1
Basin, channel dimensions
E
„
l
cubic yards
Boat ramp dimensions
Other
4
t
i 7771
�
I
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

Arthur W. Tierney �„P{ a�4S� 66-30IM1
Tdise J zerney 47 2245
P.O. Box 876
506 whittaker Pt Rd
Oriental, NC 28571 DATE
PAY TO THE
ORDER OF
.� DOLLARS
uLook for: Micro Print signature line, gray type and linework. First Citizens Bank logo on back. If not present, do not cash.
FIRST CITIZENS 472 Chwk Qfst
BANK First -Citizen Bank & Trust Company
Oriental, N.C. 28571
FOR
1:0 5 3 L00 3001:001, 7 L 70 2 2 20 gum 0 2 24 5

�)I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to /�i�T���J.e ><�L �sf /�c.e�✓F ma's
(Name of Property Owner)
property located at
on ��no
/o7/o2 G.y/-;,T6 /-/ Q�e
(Lot, Block, Road, etc.)
(Waterbody)
in Oe/E1V'7-s/ 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/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be�fllled in by individual proposing development)
-3 PO 17, 15 MO VA L
\V�
Telephone Number
Date:

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit:
Address of Property:
ldja LU,�ro,y �,P_
P
�e/'E� TW 4_ �.co C6.. 41 C.
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish -to waive the- 1-5`` es aback requirement.
I do not i h to waive 15' e�setback requirement.
Si anature Date
Pnnt Name
i34S
Telephone Number With Area Code

'ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to s
(Name of Property Owner)
property located at
on
W/02Q,P
(Lot, Block, Road, etc.)
(Waterbody)
in /lr,o e wl�71 , 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/mooring
pilings/boattift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
9 I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To bey Iled in by individual proposing development)
SPoiL �15nwvAI
f-v 6 F T .
0
A�1/e Pl�,ZAe-4zz
Print or Type Name
5,P1/--2-2© - W2?
Telephone Number
Date: 2�9/�D

NP
WE-KRLUMlYlc
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit:
Address of Property:
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
V,-'_ I have no objections to this proposal. v
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, I5I-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within IO days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive 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.
ignaturg, n Date
Print Name
Telephone Number With Area Code