61100_FACCLOLA, DANIEL AND JANINE_20121105

DAMA / 7 DREDGE &FILL
0' No. 61100
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑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 I SA NCAC
❑ Rules attached.
Applicant Name I Project Location: County
Address ! Street Address/ State Road/ Lot #(s)
City '17---J-'_State ZIP — -- —
Phone # () Fax # ( ) Subdivision
Authorized Agent City — —_ ZIP
Affected CW -!EW XPTA ❑ES F OPTS Phone # (-__) River Basin
-! OEA r-' HHF ❑ IH ElUBA N/A
AEC(s): Adj, Wtr. Body_ (nat /man /unkn�
C PWS: FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body —
Type of Project/ Activity
Pier (dock) length -
Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore_
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
v
- - _ - -- 3� - - -
Beach Bulldozing - -- - -
Other
Shoreline Length x i
SAV: not sure yes no
Sandbags: not sure yes no ^— - - -- ---
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no - l
A building permit may be required by:
Notes/ Special Conditions
AgAplicant Printed Name
Signature ** Please read compliance statement on back of permit"
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules.
Permit Officers Signature R
Issuing Date Expiration Date
Local PlanningJurisdiction _ 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, certify that this project is consistent with 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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ I-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)

Describe below the HADITAT disturbances for the applica,ion. Ali values should match the rame, and ur;its ct measurement
found in your Habitat code sheet.
Habitat !`lame
i
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied "or.
Disturbance total
includes any
anticipated
restoration or
temp impacts
FINAL Sq. Ft,
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
r FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
.72..3✓3 . "� ,. -=3 ai- ;»2uUA>i .. �ar•,r,.r.,r_r_ _ _„ 1 ,.�,� <_....r; ,.,.j...nc f �., .:7:. ,.-t. r-:1) r.; 10

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ �����k/\, 9-- (J.�G Is
(Name of Property Owner) �.
property located at
01511
(Address ,I Lot, Block, Roadetc.)
on —\�) t gs��C in ���•� ----- N.C.
(WV terbody) �S C c (� (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.
7(P a O�nr Information) (Adjacent Property Owner Information)
a Signature
'L—
Print or Type Name Print or Type Name
M ing Address Mailing Address
� c1 U Rns 2.
City/State/Zi af� ) City/State/Zip L
Telephone Number Telep oneAmber"
lL
Date Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to b 4ti leC 4- "trvL F4- cclo c A 's
I (Name of Property Owner)
property located at 8 `/ d,4 KS 6,1
onyI r�e.(Address, Lot, Block, Roa , etc.)
,4L1,e C-g- in 18, Z'r-� , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
io-
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
S-E; is- 133i-,-p c�zs
REC�iJ��
0c, 16 2012
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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.
roperly Owner Info tion) (Adjacent Property Owner Information)
SigiXture Signature -
Print or Type Nye Print or Type Name
M/ Mailing Address
K-
DWS aterLip City/5tatelLip
Telephone Nu ber Telephone Number
Dale Dale /
(Revised 61182012)

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66-30531
Cjaninejones Facciola 01-08 005 2754
Daniel Leo Facciola
418 Meeting Si
Beaufort NC 28516
rl
First Citizens A Prpm
ier
1:0 S 3 100 3001:CID00-5 76 EOO 3911' 02
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