20231713 Ver 1_Site Plan_20231218

S, Describe the existing land use or condition of the site at the time of this application ;residential,
undeveloped, etc.]:
Describe proposed work (fncljde discussion as to how hardening cf shoreline has been avoided, or
why It is necessary):
7. Will wofic be conducted from land? $- From water? ❑
8. Totai amount of impacts below the normal pool lake level/ Normal Water Level
Permanent lVpacts (including all excavation, backf`ill, rip rap, re aining walls, etc.) in square feet:
Temporary impacts in square feet:
9. Totat amount of impacts above the normal pool lake level / Normal Water Level and 50 feet land-
wa rd
Permanent impacts (lrodudbng bock fill, excavation, rip rap, retaining walls, etc,) In square feet:
3-" i
�er,porary I-npacts (ternporary clearing, construction corridor) In square feet:
10. Please describe the vegetation above the normal pool fake level/ NormaI Water Level and 54 feet
landward to be impacted (number of trees, for Instance):
11. Signature
By signing below, I, as the project proponent, certify to the following:
• The project proponent hereby certifies that all information contained herein Is true, accurate,
and complete to the best of my knowledge and belle`
• 'ate project proponent hereby requests that the certifying authority review and take actlon on
I
his CWA 401 certiftcatIon request w thin the applicable reasonable period of time
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urie is valid only if an authorimrion letter; rLm the owner is provided.
12. please approximateiy sketch the following information on this plan and pfoMe dimensions for
Cwh Iftm:
a. Ail proposed vegetation clearing
b. LoLatl:n of rip rzp ;xfIiI to be plate above the FL sand/ Normal Water Level elevation
c. Location of rip rap or fill to be placed below the Full Pored/ Normal Water Levti elevation
d. Locatioon of any proposed structures such as buildings, retaining walls, docks, etc.
e. Location Many excavation or dredging below the Full Pond/ Normal Water Level elevation
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