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QCAMA/ ❑DREDGE& FILL J_D-1�( Oct J 79868 A B C D
GENERAL PERMIT Previous permit# �Ita �
ONew ❑Modification ►'Complete Reissue ❑Partial Reissue Date previous permit issued Sf - r ®T-i
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As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC C1'14. I ZOO •
l*Rules attached.
Applicant Name QYk tkd ,,,,vv; ; Project Location: County kV 6'1
Address ZZ`5 y so A` !Street Address/State Road/Lot#(s)
City l�}0. t1141 ' State KS e•ZIP�.-nil ; 2Z S 116cr.y 'De --
Phone#an)e)gjt)-p"p4-91.4)9 E_Mail • 1 Subdivision ---f"— -
Authorized Agent Zit/AM y 1 City V wl t F�'e/ ZIP I
Affected 0 CW )EW PTA ❑ES ❑PIS 1 Phone# [�0 f )Sib' e River Basin R. i?Al^v
AEC(s): ❑Ora ❑HHF ❑IN ❑USA O NIA i Adj.Wtr.Body �.VV1�9 L.iw 4i' e tom'/rnan /unkn)
❑PWS:
ORW: yes I PNA yes / no i Closest •
Maj.Wtr.Body a P1t1 �ItOte'
Type of Project/Activity .f'falk ik,'x `i1•1
' d : / I'f)1 1 '-- L A
I'?i x‘3' h c.$l1 4- 1LI') 291 b sDe, te (scalp: ii • )
Pier(dock)length, kj'�A%SQ 1 __., ,. ._-5,-_'� 8 ��
Fixed Platform(s) I 74 1.-4. !. _l._ ;_. .i..__ _ --, ., .-_,_- , ---- i
Floating Platforms) i _ -L i $ { i ±...I -__ _'__ _-f 1_` . --
Groin length _ i r- - _.._ `•i---.---r— ••- ...
_ a�_, -i _-,_.1_?
number -- ! f--- - -li ; { ' _ .`•..•_, 1; i _,-_'.__c,_. '-_ i I ' _,_.._. j _ _�_ _ ; i_ 1 i
Bulkhead/Itiprap length i 1 , , ' -- ..,• - I 1 ,I i
a distance offshore �'
max distance offshore ! _I.�. .. _ 1 a
;__;_i_i ,
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Basin.channel - . -1_,_, ,.. ., ; ._,. �_� 1 -1,_:—_' ; .4_ ,_._ -�_ , l" i.__
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,i___:_____, __ _ _v: .___.4,s.u..,___ i _
,,,. . . : , , . . ; ;
..; __; _;:___„_.,___.,,_:,
,J_,..,...,
-' -_ ' i r ,Boat _ 1- I } . ; - ' _, --. - - -� - - : - 1- - -�1ra
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Beach Bulldozing— --' � -4- -.-,l- I_ ' .y. .. {(_1-. , 4_ -.;----,--1---;---,- k
Other - i ' i t tl ' , : e
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1-77-1
j i i S i - r-. _ i -
Shoreline Len - -_ J ' — ;
t
SAv: i - '- - -- - - . . ' -• =
Yes no '_•...-;-.._ ,- -1 -
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Moratorium: n/a yes • 1 i 7 I I i i i —
Photos: yes •( ' 1 -_i ! i 17� _
Waiver Attached: yes 'i ' ' 1 ; , _L_ L _L L• l
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A building permit may be required by: l t"\" D - 1 ❑See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1, a
id 7.
' Notes/Special Conditions La+ ) C /4PtLi ie-aye) 4111.4...41 .
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S49-t,e-yr-'--- 44 graP\if
Age Applicant Prinn N P t0 c s Printed N
a..........
.1"44.44
k
Signature *e Please read compliance tementon back ofpermit"N° Signature
Crill K en a s► .�.2 i50 i 30 - -5 y -aoar - 30 -t4o.%;- e
Application Fee(s) Check# Issuing Date Expiration Date
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