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HomeMy WebLinkAbout20090526 Ver 1_401 Application_2009050909-0526 pA1 May 5, 2009 NC Division of Water Quality Attn: Cyndi Karoly 401 /Wetlands Unit 1650 Mail Service Center Raleigh, NC 27699-1650 Michael Baker Engineering, Inc. 797 Haywood Road Suite 201 Asheville, North Carolina 28806 828-350-1408 FAX 828-350-1409 Qcc??od?? MAY 0 g 2009 DENR - WATER QUALITY WETLANDS AND STORMWATER BRANCH Subject: Preconstruction Notification and request for 404 and 401 permits for farm access improvements on property belonging to Mr. and Mrs. David Thomas of Madison County, NC. Unnamed Tributary to Ivy Gap Branch, French Broad River Basin - CU# 06010105, Madison County, NC. Dear Ms. Karoly: Enclosed with this letter are five (5) copies of the Pre-Construction Notification and other pertinent information that are being submitted for regulatory review. I have also attached to the PCN a check for $240.00 to cover the application fee. Baker has signed an MOU with the DWQ for electronic submission of applications and we have attempted to follow the DWQ's guidance with this. In addition I have sent one additional copy directly to Kevin Barnett to save your office the time and expense of forwarding it to him. We have also submitted this information to the U.S. Army Corps of Engineers and N.C. Wildlife Resources Commission for their review. We are providing this information for your department's consideration and comments relative to permitting under §401 of the Clean Water Act. Mr. and Mrs. David Thomas of 5684 U.S. Highway 19E, Mars Hill, NC wish to restore the use of a small road used to access their pasture land. The original entry onto the access road was removed during the state's highway expansion project currently underway on Highway 19E. As a result, the Thomas' are no longer able to access their pasture land from this road. The proposed project would enable the landowners to reclaim this access by building a segment of gravel road off their existing driveway that would tie into the portion of the existing road access not disturbed by the state transportation project. In order to accomplish this, up to 125 linear feet (LF) of an unnamed tributary would be placed in an 18" culvert. The project reach is a small, second order tributary to Ivy Gap Branch. Ivy Gap Branch is located in a Water Supply Watershed, therefore requiring a stormwater management review of the project by Madison County's Zoning Administrator. The County's concurrence with this project as proposed is included in this submittal. The preconstruction notice should provide the information needed to evaluate this permit request and we are prepared to meet with personnel from your office to further discuss the project, if you so desire. Thank you for your consideration of this request. If you have any questions, please feel free to contact me at 828-350-1408 ext. 2010. Your timely review will be appreciated. Sincerely, O t.-Ew 40"t- M`JdT"JM% Carmen Horne-McIntyre Project Manager, Michael Baker Engineering, Inc. 09-0526 C1 WA i Office Use Only: Corps action ID no. DWQ project no. Form Version 1.3 Dec 10 2008 Pre-Construction Notification (PCN) Form A. Applicant Information 1. Processing 1 a. Type(s) of approval sought from the Corps: ®Section 404 Permit El Section 10 Permit 1b. Specify Nationwide Permit (NWP) number: 40 or General Permit (GP) number: 1 c. Has the NWP or GP number been verified by the Corps? ® Yes ? No 1 d. Type(s) of approval sought from the DWQ (check all that apply): ® 401 Water Quality Certification - Regular ? Non-404 Jurisdictional General Permit ? 401 Water Quality Certification - Express ? Riparian Buffer Authorization 1 e. Is this notification solely for the record because written approval is not required? For the record only for DWQ 401 Certification: ? Yes ® No For the record only for Corps Permit: ? Yes ® No 1f. Is payment into a mitigation bank or in-lieu fee program proposed for mitigation of impacts? If so, attach the acceptance letter from mitigation bank or in-lieu fee program. ? Yes ® No 1g. Is the project located in any of NC's twenty coastal counties. If yes, answer 1 h below. ? Yes ® No 1 h. Is the project located within a NC DCM Area of Environmental Concern (AEC)? ? Yes ® No 2. Project Information 2a. Name of project: Thomas Property: Farm Access Improvement Project 2b. County: Madison 2c. Nearest municipality / town: Mars Hill 2d. Subdivision name: I 2e. NCDOT only, T.I.P. or state project no: MAY U 3. Owner Information 3a. Name(s) on Recorded Deed: David and Elaine Thomas WET1AlYDSA446STORMWAtERBRANCFI 3b. Deed Book and Page No. 344/699 3c. Responsible Party (for LLC if applicable): David and Elaine Thomas 3d. Street address: 5684 U.S. Highway 19E 3e. City, state, zip: Mars Hill, NC 28754 3f. Telephone no.: 828.689.2821 3g. Fax no.: 3h. Email address: ethomas@madison.k12.nc.us Page 1 of 11 PCN Form - Version 1.3 December 10, 2008 Version 4. Applicant Information (if different from owner) 4a. Applicant is: ® Agent ? Other, specify: 4b. Name: Carmen Horne-McIntyre 4c. Business name (if applicable): Michael Baker Engineering, Inc. 4d. Street address: 797 Haywood Rd., Suite 201 4e. City, state, zip: Asheville, NC 28806 4f. Telephone no.: 828.350.1408 ext. 2002 4g. Fax no.: 828.350.1409 4h. Email address: cmcintyre@mbakercorp.com 5. Agent/Consultant Information (if applicable) 5a. Name: Carmen Horne-McIntyre 5b. Business name (if applicable): Michael Baker Engineering, Inc. 5c. Street address: 797 Haywood Rd., Suite 201 5d. City, state, zip: Asheville, NC 28806 5e. Telephone no.: 828.350.1408 ext. 2010 5f. Fax no.: 828.350.1409 5g. Email address: cmcintyre@mbakercorp.com Page 2 of 11 PCN Form - Version 1.3 December 10, 2008 Version B. Project Information and Prior Project History 1. Property Identification 1a. Property identification no. (tax PIN or parcel ID): 9757-13-6222 1 b. Site coordinates (in decimal degrees): Latitude: 35.8983 Longitude: - 82.4722 (DD.DDDDDD) (-DD.DDDDDD) 1c. Property size: 62.07 acres 2. Surface Waters 2a. Name of nearest body of water (stream, river, etc.) to Ivy Gap Branch proposed project: 2b. Water Quality Classification of nearest receiving water: WS-II; HQW 2c. River basin: French Broad 3. Project Description 3a. Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this application: The project site is located on a private landowner's property adjacent to Highway 19N just east of the Bethel community off Exit 9 of U.S. Highway 26 West. The property on which the proposed project is located consists of a residence and pastureland. Notable features within the vicinity of the proposed project area include a small shed, a driveway leading to the residence, an unnamed tributary (UT1) and the remnants of a small road used to access the landowner's pastureland. 3b. List the total estimated acreage of all existing wetlands on the property: 0 3c. List the total estimated linear feet of all existing streams (intermittent and perennial) on the property: 248 LF.Most shown as "blue line streams" are actually ephemeral. 3d. Explain the purpose of the proposed project: The purpose of the project is to restore the use of a small road used by the landowners to access their pastureland. The original entry onto the access road was removed during the state's highway expansion project currently underway on Highway 19E. As a result, the landowners are no longer able to access their pastureland from this road. The proposed project would enable the landowners to reclaim this access by building a segment of gravel road off of their existing driveway. This road segment would be tied into the portion of the existing road access not disturbed by the state transportation project. In order to accomplish this, up to 125 LF of the unnamed tributary would be placed in an 18' culvert extension to allow for the road access. 3e. Describe the overall project in detail, including the type of equipment to be used: Up to 125 LF of UT1 is proposed to be filled to facilitate the reestablishment of a farm road. The restored farm road would be approximately 10' wide with a 2:1 slope on the upstream-facing slope. An existing culvert used to transport UT1to Ivy Gap Branch will be extended and fill placed over the culvert extension. The fill slope between the farm road and Highway 19 will be on a 2:1 or more gradual slope that ties into the existing ground level adjacent to the shoulder of Highway 19. A pre-formed head wall will be installed at the culvert inlet. This project will require the use of track-hoes, dozers for grading and clearing activities, and dump trucks to haul materials. Access to the project site will occur from the existing driveway and the undisturbed segment of farm road remaining. Page 3 of 11 PCN Form - Version 1.3 December 10, 2008 Version 4. Jurisdictional Determinations 4a. Have jurisdictional wetland or stream determinations by the Corps or State been requested or obtained for this property / project (including all prior phases) in the past? Comments: Jurisdictional determinations have been ? Yes ® No ? Unknown requested for other unnamed tributaries on this property for improvements to the landowner's agricultural land. However, those improvements are unrelated to this project. 4b. If the Corps made the jurisdictional determination, what type ? Preliminary ®Final of determination was made? 4c. If yes, who delineated the jurisdictional areas? Agency/Consultant Company: Michael Baker Name (if known): Engineering, Inc. Other: 4d. If yes, list the dates of the Corps jurisdictional determinations or State determinations and attach documentation. The agent received verification by email on 5/5/09 that the Corps approved jurisdictional determinations noted in 4a. 5. Project History 5a. Have permits or certifications been requested or obtained for ? Yes ® No ? Unknown this project (including all prior phases) in the past? 5b. If yes, explain in detail according to "help file" instructions. 6. Future Project Plans 6a. Is this a phased project? ? Yes ® No 6b. If yes, explain. Page 4 of 11 PCN Form - Version 1.3 December 10, 2008 Version C. Proposed Impacts Inventory 1. Impacts Summary 1 a. Which sections were completed below for your project (check all that apply): ? Wetlands ® Streams - tributaries ? Buffers ? Open Waters ? Pond Construction 2. Wetland Impacts If there are wetland impacts proposed on the site, then complete this question for each wetland area impacted. 2a. 2b. 2c. 2d. 2e. 2f. Wetland impact Type of jurisdiction number - Type of impact Type of wetland Forested (Corps - 404, 10 Area of impact Permanent (P) or (if known) DWQ - non-404, other) (acres) Temporary T - W1 ? P ? T ? Yes ? Corps ? No ? DWQ W2 ? PEI T ? Yes ? Corps ? No ? DWQ W3 ? P ? T ? Yes ? Corps ? No ? DWQ W4 ? P ? T ? Yes ? Corps ? No ? DWQ W5 ? P ? T ? Yes ? Corps ? No ? DWQ W6 ? P ? T ? Yes ? Corps ? No ? DWQ 2g. Total wetland impacts 2h. Comments: There are no wetlands within the area included in this request or on this property. 3. Stream Impacts If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site, then complete this question for all stream sites impacted. 3a. 3b. 3c. 3d. 3e. 3f. 3g. Stream impact Type of impact Stream name Perennial Type of jurisdiction Average Impact number - (PER) or (Corps - 404, 10 stream length Permanent (P) or intermittent DWQ - non-404, width (linear Temporary (T) (I NT)? other) (feet) feet) Si ®P ? T culvert/fill UT1 ? PER ® INT ® Corps ? DWQ 2 100 S2 ? P ? T ? PER ? Corps ? INT ? DWQ S3 ? P ? T ? PER ? Corps ? INT ? DWQ S4 ? P ? T ? PER ? Corps ? INT ? DWQ S5 ? P ? T ? PER ? Corps ? INT ? DWQ S6 ? P ? T ? PER ? Corps [:1 INT ?DWQ 3h. Total stream and tributary impacts 100 3i. Comments: The remaining 25 feet of channel proposed to be culverted is emphemeral. Page 5 of 11 PCN Form - Version 1.3 December 10, 2008 Version 4. Open Water Impacts If there are proposed impacts to lakes, ponds, estuaries, tributaries, sounds, the Atlantic Ocean, or any other open water of the U.S. then individually list all open water impacts below. 4a. 4b. 4c. 4d. 4e. Open water Name of waterbody impact number - (if applicable) Type of impact Waterbody type Area of impact (acres) Permanent (P) or Tem ora T 01 ?P?T 02 ?P?T 03 ?P?T 04 ?P?T 4f. Total open water impacts 4g. Comments: None 5. Pond or Lake Construction If and or lake construction proposed, then complete the chart below. 5a. 5b. 5c. 5d. 5e. Wetland Impacts (acres) Stream Impacts (feet) Upland Pond ID Proposed use or purpose (acres) number of pond Flooded Filled Excavated Flooded Filled Excavated Flooded P1 P2 K Total 5g. Comments: 5h. Is a dam high hazard permit required? ? Yes ? No If yes, permit ID no: 5i. Expected pond surface area (acres): 5j. Size of pond watershed (acres): 5k. Method of construction: 6. Buffer Impacts (for DWQ) If project will impact a protected riparian buffer, then complete the chart below. If yes, then individually list all buffer impacts below. If an impacts require mitigation, then you MUST fill out Section D of this form. 6a. ? Neuse ?Tar-Pamlico ? Other: Project is in which protected basin? ? Catawba ? Randleman 6b. 6c. 6d. 6e. 6f. 6g. Buffer impact number- Reason Buffer Zone 1 impact Zone 2 impact Permanent (P) or for Stream name mitigation (square feet) (square feet) Temporary T im act required? - B1 ?P?T ?Yes ? No B2 ?P?T ?Yes ? No B3 ?P?T ?Nos 6h. Total buffer impacts 6i. Comments: Page 6 of 11 PCN Form - Version 1.3 December 10, 2008 Version D. Impact Justification and Mitigation 1. Avoidance and Minimization 1 a. Specifically describe measures taken to avoid or minimize the proposed impacts in designing project. A stream crossing is unavoidable if this landowner is to reestablish road access to his pasture from his driveway. A drainage route for the property occurs between the landowner's driveway (located on a steep sideslope on the right bank) and his pasture also a steep slope on the left bank. Access will be gained by extending the existing culvert and filling to the elevation of the existing driveway, highway and old road. The crossing will be close to the highway at nearly a 90-degree angle and connecting to the old road. The length of stream impacted is based in large part on the elevation of the landowner's driveway and the elevation of the road shoulder in relation to the elevation of the channel which is much lower than the driveway or road shoulder. To get at least a 2:1 slope to the channel will require extending the existing culvert. This approach will result in less impact than if a separate 90-degree crossing was made from the drive, because that approach would result in two side slopes from the access road to the channel. Vegetated swales constructed to NCDENR BMP specifications will be used to divert runoff from the gravel access to the vegetated buffer adjacent to UT1. 1 b. Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques. Work will be performed during dry weather. Stream flow is insufficient to justify stream diversion. The bottom of the culvert will be placed several inches into the existing stream bed to facilitate aquatic passage during drought or low flow conditions. Every effort will be made to maintain a channel slope similar to that which currently exists. Erosion control measures will consist of reinforced silt fencing around the headwall and base of the fill. Road bed material will consist of large gravel. The slopes of the berms of the road and fill that is extended a short distance will be fertilized and seeded as soon as slopes are brought to a final grade. In addition, a series of trees will be planted on the downslope end of the farm access. These trees will provide further site stabilization and will also provide a limited screen and noise barrier from the highway for the landowners. 2. Compensatory Mitigation for Impacts to Waters of the U.S. or Waters of the State 2a. Does the project require Compensatory Mitigation for ? Yes ® No impacts to Waters of the U.S. or Waters of the State? 2b. If yes, mitigation is required by (check all that apply): ? DWQ ? Corps ? Mitigation bank 2c. If yes, which mitigation option will be used for this El Payment to in-lieu fee program project? ? Permittee Responsible Mitigation 3. Complete if Using a Mitigation Bank 3a. Name of Mitigation Bank: 3b. Credits Purchased (attach receipt and letter) Type Quantity 3c. Comments: 4. Complete if Making a Payment to In-lieu Fee Program 4a. Approval letter from in-lieu fee program is attached. ? Yes 4b. Stream mitigation requested: linear feet 4c. If using stream mitigation, stream temperature: ? warm ? cool ?cold 4d. Buffer mitigation requested (DWQ only): square feet 4e. Riparian wetland mitigation requested: acres 4f. Non-riparian wetland mitigation requested: acres 4g. Coastal (tidal) wetland mitigation requested: acres 4h. Comments: 5. Complete if Using a Permittee Responsible Mitigation Plan Page 7 of 11 PCN Form - Version 1.3 December 10, 2008 Version 5a. If using a permittee responsible mitigation plan, provide a description of the proposed mitigation plan. 6. Buffer Mitigation (State Regulated Riparian Buffer Rules) - required by DWQ 6a. Will the project result in an impact within a protected riparian buffer that requires buffer mitigation? ? Yes ® No 6b. If yes, then identify the square feet of impact to each zone of the riparian buffer that requires mitigation. Calculate the amount of mitigation required. Zone 6c. Reason for impact 6d. Total impact (square feet) Multiplier 6e. Required mitigation (square feet) Zone 1 3 (2 for Catawba) Zone 2 1.5 6f. Total buffer mitigation required: 6g. If buffer mitigation is required, discuss what type of mitigation is proposed (e.g., payment to private mitigation bank, permittee responsible riparian buffer restoration, payment into an approved in-lieu fee fund). 6h. Comments: Page 8 of 11 PCN Form - Version 1.3 December 10, 2008 Version E. Stormwater Management and Diffuse Flow Plan (required by DWQ) 1. Diffuse Flow Plan I a. Does the project include or is it adjacent to protected riparian buffers identified ? Yes ® No within one of the NC Riparian Buffer Protection Rules? 1 b. If yes, then is a diffuse flow plan included? If no, explain why. ? Yes ? No Comments: 2. Stormwater Management Plan 2a. What is the overall percent imperviousness of this project? <10 % 2b. Does this project require a Stormwater Management Plan? ? Yes ® No 2c. If this project DOES NOT require a Stormwater Management Plan, explain why: This project would be considered a low density project. Activities proposed will not result in the creation of greater than 24% impervious surface area across the project area. Runoff from the gravel farm access will be transported via a vegated swales constructed in accordance with the most recent version of the NCDENR BMP Manual. 2d. If this project DOES require a Stormwater Management Plan, then provide a brief, narrative description of the plan: ? Certified Local Government 2e. Who will be responsible for the review of the Stormwater Management Plan? ? DWQ Stormwater Program ? DWQ 401 Unit 3. Certified Local Government Stormwater Review 3a. In which local government's jurisdiction is this project? Madison County ? Phase II 3b. Which of the following locally-implemented stormwater management programs ? NSW ? USMP apply (check all that apply): ® Water Supply Watershed ? Other: 3c. Has the approved Stormwater Management Plan with proof of approval been ® Yes ? No attached? 4. DWQ Stormwater Program Review ? Coastal counties ? HQW 4a. Which of the following state-implemented stormwater management programs apply ? ORW (check all that apply): ? Session Law 2006-246 ? Other: 4b. Has the approved Stormwater Management Plan with proof of approval been attached? ? Yes ? No 5. DWQ 401 Unit Stormwater Review 5a. Does the Stormwater Management Plan meet the appropriate requirements? ? Yes ? No 5b. Have all of the 401 Unit submittal requirements been met? ? Yes ? No Page 9 of 11 PCN Form - Version 1.3 December 10, 2008 Version F. Supplementary Information 1. Environmental Documentation (DWQ Requirement) 1 a. Does the project involve an expenditure of public (federal/state/local) funds or the ? Yes ® No use of public (federal/state) land? 1 b. If you answered "yes" to the above, does the project require preparation of an environmental document pursuant to the requirements of the National or State ? Yes ? No (North Carolina) Environmental Policy Act (NEPA/SEPA)? 1c. If you answered "yes" to the above, has the document review been finalized by the State Clearing House? (If so, attach a copy of the NEPA or SEPA final approval ? Yes ? No letter.) Comments: 2. Violations (DWQ Requirement) 2a. Is the site in violation of DWQ Wetland Rules (15A NCAC 2H .0500), Isolated Wetland Rules (15A NCAC 2H .1300), DWQ Surface Water or Wetland Standards, ? Yes ® No or Riparian Buffer Rules (15A NCAC 2B .0200)? 2b. Is this an after-the-fact permit application? ? Yes ® No 2c. If you answered "yes" to one or both of the above questions, provide an explanation of the violation(s): 3. Cumulative Impacts (DWQ Requirement) 3a. Will this project (based on past and reasonably anticipated future impacts) result in ? Yes ® No additional development, which could impact nearby downstream water quality? 3b. If you answered "yes" to the above, submit a qualitative or quantitative cumulative impact analysis in accordance with the most recent DWQ policy. If you answered "no," provide a short narrative description. 4. Sewage Disposal (DWQ Requirement) 4a. Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of wastewater generated from the proposed project, or available capacity of the subject facility. Page 10 of 11 PCN Form - Version 1.3 December 10, 2008 Version 5. Endangered Species and Designated Critical Habitat (Corps Requirement) 5a. Will this project occur in or near an area with federally protected species or ? Yes ® No habitat? 5b. Have you checked with the USFWS concerning Endangered Species Act ? Yes ® No impacts? El Raleigh 5c. If yes, indicate the USFWS Field Office you have contacted. ? Asheville 5d. What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical Habitat? USFWS and NC Natural Heritage Program (NCNHP) species listings for Madison County; NCNHP mapping tools 6. Essential Fish Habitat (Corps Requirement) 6a. Will this project occur in or near an area designated as essential fish habitat? ? Yes No 6b. What data sources did you use to determine whether your site would impact Essential Fish Habitat? http://ocean.floridamadne.org/efh_coral/ims/viewer.htm, USFWS information for Madison County 7. Historic or Prehistoric Cultural Resources (Corps Requirement) 7a. Will this project occur in or near an area that the state, federal or tribal governments have designated as having historic or cultural preservation ? Yes ® No status (e.g., National Historic Trust designation or properties significant in North Carolina history and archaeology)? 7b. What data sources did you use to determine whether your site would impact historic or archeological resources? SHPO Computer Mapping and Google Earth National Register layers (http://www.hpo. ncdcr.gov/digital/NCH PO_Digital_Start_Page. html#S u rvey_Databases ) 8. Flood Zone Designation (Corps Requirement) 8a. Will this project occur in a FEMA-designated 100-year floodplain? ? Yes ® No 8b. If yes, explain how project meets FEMA requirements: 8c. What source(s) did you use to make the floodplain determination? On-line mapping at http://www.ncfloodmaps.com Carmen Horne-McIntyre ?0?? 1,t ryc? i l5 it 0`a Applicant/Agent's Printed Name Applicant/Agent's Signature Date (Agent's signature is valid only if an authorization letter from the applicant is provided.) Page 11 of 11 PCN Form - Version 1.3 December 10, 2008 Version April 22, 2009 Ms. Liz Hair, Project Manager Asheville Regulatory Field Office U.S. Army Corps of Engineers 151 Patton Avenue, Room 208 Asheville, North Carolina 28801 Reference: Agent Authorization and Site Access Authorization Pre-Construction Notification Mr. and Mrs. David Thomas Property 5684 U.S. Highway 19E Mars Hill, Madison County, North Carolina Dear Ms. Hair: As the property owner, I am hereby authorizing you and/or other employees of the U.S. Army Corps of Engineers (USACE), Asheville Regulatory Field Office, to enter and inspect the above- referenced project site. I understand that this site inspection will further your agency's consideration in the issuance of a Nationwide #40 Permit for farm access improvements that will involve the crossing of surface waters protected under the USACE Section 404/401 Regulatory Program. Additionally, as the property owner, I hereby authorize Michael Baker Engineering, Inc. to act as my authorized agent regarding submittal of a formal request for a stream determination on my property. Please contact me if you need additional information. Sincerely, o?•.a/? ?(a?r,e ltio? s (Owner Signature) (Print Name) (Date) v& R q 1 5 i4 c Mars _S751 '?z'? ???-asap (Phone No.) (Address) Little Ivy Creek Watershed HUC #06010105 Watershed Area: 46.39 Sq t lA L E t It tl-v P- --- a , 50 . Approximate location of NCDOT Right-of-way " Z/1 LEGEND: Figure I USGS Topographic Map - Streams (Bald Creek Quadrangle) Drainage area Thomas Property Farm Access Improvement Project 0 400 800 1,600 Madison County, NC Feet A Thomas Property: Farm Access Improvements Photo Log - Project Area ?' RR °TMy qc - rY4 ilk 3f-. ?y a k Photo 1: Vie%y ofprojeet area li`om residence. I'I1;aa Proposed location of new term access. 9?, r 71- Photo 5. Channel conditions downstream of reservoir. Roughly 25 If of the channel in this location would be placed in a culvert. Photo 2: View of remaining- farm access. Photo 4. Overflow from landowner's reservoir upstream of project area. Photo 6. Approximately 100 If of intermittent channel would be Photo 7. Intermittent channel. MAdlaom COMW Ww=6•d PrvtUdoa Ordieamce DOW Of F*rm' , DWU*ar 16. 1993 Watershed Protection Pamft Application Application No. Date Filed J 41 #? Date Approved Applicant Address c tk% Ob a Kl LE 'J 0? -a Z ob Telephone: (W) !126. . iso. !'tv 4 T Yo a ig 3so, ,l?s s ?109 OWOW DAv IA 4 1=ut#, r, Tm444 r Address O ?' s' l jK/tw ! F a G -? Telephone: (pr) (h) Ism. 6 SM, 2414 Surveyor Phone &t&eer (if applicable) Pbm* Property LD. Number L'br all parcels q-rS? - 3 6 Gz?- Deed Sook and Page NUmmber(s) .3y?9 Tip Watershed Name 4 -rn Iv c e ?T Aare?e GZ.a? Critical Meal Yea 9i NO Porenn}v $t on ProA?APIy for 10/y0 prgvlsion Yea .?. No P Yea No Check all that apply. addition to as existing atructttts (___ residential:.. commercial; - other -•Pleaw mcplain) new structure (_ roWdmritial; , commwcW; manufu tuured Lome - other -- A addition to built-upon uft Cmduding Paved and 8avel paining and loading aplitie#, dflveways, sidewalks grid otlur areas that meet the defttion in the Watershed Protection Ordinance), General description of work under this application: _CWK IbR/1AC of TME Prb:11?Gt It T? ItWoR6 W dt9 rF A sMaff.R?M USED 6y 7HR LxWOk?-C. i1u4st 1rIFIL( PAS?T?f?tQ. 11tt s,JGd ?! AD w 6 '? s +S ?kPMc w1 I?.?FG7??eANT vJ ulS 1?, The Plloposgp p0410VT on WO F ,4mxe T45 wwDOWAX" 7i 1G6G?,MM TOIL *TwB Ry 131ambk46 4 te6,jc-jn aF 604vSL g.Ao or-F I certify that the intbrfnation above is true and accurate, L-W is is aontPHAnec with the conditions for the develap- mem of land as defied in the Watershed Protection Ordlrtar m ????a ?.r.?rti- WI `!.+ z„? 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