34080_WICKIZER, STEVE_20030627

.❑ICAMA / ❑ DREDGE & FILL
^GENERAL PERMIT /�•
Previous permit #
❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
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 15A NCAC
❑ Rules attached.
Applicant Name
Address
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t-_ , C
City
-- State
ZIP '>� - r�
Phone # ( )
Fax # (
)
Authorized Agent
Affected ❑ CW
❑ EW ❑ PTA ❑ ES
❑ PTS
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no
Crit. Hab. yes / no
Project Location: County_
Street Address/ State Road/ Lot #(s)
Subdivision
City. ZIP.
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature a Please read compliance statement on back of permit **
Application Fee(s) Check #
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Permit Officer's Signature
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Issuing Date -4pimtich Date
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
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 or criminal 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 officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

STEPHEN D. WICKIZER NCDL 1801179
PHYLLIS M. WICKIZER NCDL 2160252
207 BROOK LANE 252-726-6776
P.O. BOX 922
MOREHEAD C NC 28557
Pay to the /
Order of—s;l,��—�
+ First Fi t.
Havelock, NC 28532
For 6F>#
720
66-7538/2531
22
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Dollars 8�
1: 2 5 3 L 7 5 38 41: L01300 288 6 20 Sum 0 7 20

TlJfi �;� l,i j_ `r3X. .tii -1 JL I,nn F '� �� 1 1 �� { QT' A -° .?L7
(: OR ,? PIER/U:���Cn'�rRED BOAT Ljl
I hereby certiFy that I ol.4n property adiacent to ��' 1% 1� j� �Z L-- _'s
(N:f me of Property Omer)
property located at C 44KN�iT-
(Lot, Bloc Road, etc.) r
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on yrill� i2 -in ' �' � A N: C.
(ti�aterb.�dy) (Town and/or County)
He has desc.-ibed to me, as shown below, the deve!cprhent he is proposing at that
location, and, I have no objections to his proposal. I understand ijhat a pieriuncovered boat IiC_
must be set back a minimum distance of fifteen fit (15') from my area of riparian access unless
waived by me.
Ido not wish to waive the se„back.reauirement.
1� I do wish to waive that setback requirement.
------------------------------------ —--------------------------------- !----------------------------------
DESCRI_PI4I0'i A-N-D/OR DRAVVENG OF PRO POSED';DEVELOPNjTN-r:
(To be filled in bv individual proposing deveZbpment) O /
LAP
to K10
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Telephone Nu rT
Date: rep • -
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(: OR A PIER%UNCOVERED BOAT L07)
I hereby ce;rify that I o,.4n property adjacent to JAJ C�2 1 's
j�,�,, ,' t
e of Property Owner)
property located at S F1-r _ _V ff 5EC t 6
(Lot, Block, oad, etc.) 1
on�1J�tItr1W
(Waterbodv) (Town and/or. County)
He has desc._ibed to me, a_s shown below•, the developrhent he is proposing at tl:at
location, and, I have no obje_-bons to his proposal. I understand I�hat a pier/uncovered boat [it-t
must be se: back a minimum distance or rttte-n fe°t (115') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
-------------------------------------------------------------, ----------------I----------------------------------
DESCRIPVO�i k'N-D/OR DRAWLNG OF•PRO POSED: DEVELOPNM'N-r:
(To be fdkd in by individual proposing devel pment)
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