20395D - Nicholson

CAMA AND DREDGE AND FILL
GENERAL 1'i 020395 -b
PERMIT ' -kis
as authorized by the State of North Carolina
0 Department of Environment, Health,and Natural Resources and the Coastal Resources Corn�? sion
in an area of environmental concern pursuant to 15A NCAC •,71( • /) QO , ) •//4-1
Applicant N e /ILOM4 S g• /V �1 a/SG"' �' Phone Number (33 ‘) c577
Address V/,1 6.-?°GOrh&-7DLJti I'cI
City C5vie'(- S aokU State (U' C° Zip -7 7 t�U 7
Pro' ctLoccaatio (County, State Road, W ter Body, etc.) L O-71 �� ' /�,S °
l;7-=-I .0 y �,(`T ,vk?4 ti-/'y{4 L7-e 14n/s� / r 4'it•D-e ms .
Type of Project Activity // '; ia/sr� j>« '`1 i)
PROJ ECT DESCRIPTION SKETCH (SCALE: ' �� Q )
Pier(dock)length + 31
Groin length .----s‘
number
Bulkhead length J
max.distance offshore de f r
1 cli
Basin,channel dimensions 1
4&D f)
cubic yards Q k c 4" 4
F/Boat ramp dimensions Jr 1
41
Other C .......S,ILT .._.4 V ,
� /, XE'� •
f, /J ` )(I3
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, applicant's signature
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 This
officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- - .3-3- 00 e - 3 - U�'
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no �� UU -2 //UCH
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that kc?) O U C� - f /•.L p
this project is consistent with the North Carolina Coastal application fee ' /
Management Program.

DIVISION OF CQ , MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name Of Individual Applying For Permit: M v rl A-S NI VMz,L ,.-1 ' L
Address Of Property: —l Cl r E !; 1
10P5Atk, ( t1�.bf , tLL
(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 crocose_d. ulease write the
Division of Coastal Mana_ar in lt._ 127 Cardinal eve Extension.
Wilmi.neton. North Carolina, 28405 or cal 910 355-3900 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
WAR SECTION
I understand that a pier, dock, moorinc pilings, breakwater, boat
house, lift or sandbars must be set back a minim,,,,,
distance of 15'
from my area of riparian access unless waived by me. (If you wish
to waive the setback, you gist initial the appropriate blank
below.)
I do wish to waive the 15'sethack reauirement.
I do not wish to waive the 15'setback requirement.
•
/
) 1-2
Signature I Date
• r O. t i t.►yi,LsN Print Name,
• 31 o LyS
Telephone Number With Area Code

;From Nicholson Flooring to 1-919-528-3822 at 5/16/00 6:06 PM Pg 002/002
AI1'? 'CAN'1.__ UMANTA , ' ARTY 0 . 5 F= D TL LUB_FoRt
Name Of Individual, Applying For Permit: `11.14 it '(..,5 1
Address Of. Property: L4)( 6,A V; 417
A IL- - C�.
(Lot or Street #, Street or Road, City & County)
I hereby certify that I prom 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 beprovided with this letter.
,a. _ I have no objections to this proposal.
If ypu bred-tip to Wha is . e LT ►r O ed r�iease t�r� +fig be
alaslson o C as •��Q. tn. ..I 7. bna ►rir.-.�cten�gioza.
Wi1minat�a Car ina- 28Q0s or no, en n. 9 „Q0wit#i ID
co der+e3.tip lam
as no ob j f tin if ypu have.been..P�_=fisi gied M i1
MaIVAR ICI
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set back a minimum distance of 1,5'
from my area of riparian access unless, waived'by me. (If you wish
to waive the setback, you must initial the appropriate blank
below.)
84 IL I do wish to waive the 15'setba
alc requirement.
X do not wish to waive the 15'setback reguuir ement.0,1
6/6 /
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azure Pate
rint Name
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Te ep one Number With Areaode

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THOMAS E. NICHOLSON JR. I s('1 D i 04
JAYNE W. NICHOLSON
4111 GROOMETOWN RD.
GREENSBORO, NC 27407 Date 5 Z �l 00 82-15/311
Pay to the k 1
Order of '` �J
�� No a� $ ( 0
AGEdRrurls Do
Ilars ar t"'
PNC BANK
Wilmington,Delaware
For__
OVP
1:03 l i00157,: 194 1 34984 n' p 1 4
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