20090607 Ver 1_CAMA Application_20090527

A 1F4 09-0607
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director ?
p ?11Q V L5
Secretary
May 22, 2009
MEMORANDUM
MAY 2 7 2009
DENR . WATER GUAM
WETLY" AND SToRMWATER BRANCH
TO: Cyndi Karoly
Environmental Biological Supervisor
Division of Water Quality
FROM: Doug Huggett
Major Permits Processing Coordinator
SUBJECT: CAMA/DREDGE & FILL Permit Application Review
Applicant: Windsor Jacques
Project Location: 51170 & 51172, Lassiter Lane, Wind-Haven Shores, Frisco, Dare Co.
Proposed Project: Bulkhead, backfill Coastal Wetlands, dock, mooring piles
Please indicate below your agency's position or viewpoint on the proposed project and return this
form by 06/12/09 to 400 Commerce Avenue, Morehead City, NC 28557. If you have any
questions regarding the proposed project, please contact Claudia Jones at [phone]. When
appropriate, in-depth comments with supporting data are requested.
REPLY: This agency has no objection to the project as proposed.
This agency has no comment on the proposed project.
This agency approves of the project only if the recommended changes are
incorporated. See attached.
This agency objects to the project for reasons described in the attached
comments.
SIGNED
1367 US 17 South, Elizabeth City, NC 27909
Phone: [phone] FAX: [phone] ; Internet: www.nccoastalmanagement.net
DATE
An Equal Opportunity 1 Affirmative Action Employer
No One
hCarohna
Natwully

DIVISION OF COASTAL MANAGEMENT
FIELD INVESTIGATION REPORT
1. APPLICANT'S NAME: Windsor M. Jacques and Eunice L. Jacques
2. LOCATION OF PROJECT SITE: 51170 & 51172 (Lots 26 and 27) Lassiter Lane
(SR1298) (southwest side), adjacent to man-made canal off of Pamlico Sound, Wind-
Haven Shores, Frisco, Dare County
Photo Index - 2006: 172-7877 (08, P8) 2000: 172-2018 (P7, P8)
1995: 172-1763 ((N20, 020) 1989: 5-199-5 (07)
1984: 145-389145-389 (N 12, 012) 1978: 90-1369 (A2, A3)
State Plane Coordinates - X: 3014624 Y: 564918
Rover File: B050111 A USGS Map: Buxton (LL)
3. INVESTIGATION TYPE: CAMA/Dredge & Fill
4. INVESTIGATIVE PROCEDURE: Dates of Site Visit - May 1, 2009
Was Applicant Present - No
5. PROCESSING PROCEDURE: Application Received Complete - May 5, 2009
Office - Elizabeth City
6. SITE DESCRIPTION:
(A) Local Land Use Plan - Dare County
Land Classification from LUP - Limited Transition, and Conservation (AECs)
(B) AEC(s) Involved: Coastal Wetlands, Estuarine Waters, Estuarine Shoreline,
Public Trust Area
(C) Water Dependent: Yes
(D) Intended Use: Private
(E) Wastewater Treatment: Existing - Private septic
Planned - N/A
(F) Type of Structures: Existing - Single family residence, greenhouse,
driveway, bulkhead, dock
Planned - replacement bulkhead, dock, mooring piles
(G) Estimated Annual Rate of Erosion: None, both lots are bulkheaded
Source - DCM Field Observation
7. HABITAT DESCRIPTION: [Areas of Impact]
DREDGED FILLFn OTHFR
(A) Coastal Wetland 60 sq ft 60 sq ft
shading
(B) Estuarine Shoreline 3,340 sq ft
bulkhead
replacement
(C) Public Trust Area/ Estuarine 274 sq ft 274 sq ft
Water (shallow bottom) shading
Field Investigation Report
Jacques - Frisco, Dare County
Page 2
(D) Total Area Disturbed: 4,008 sq ft (0.092 acres)
(E) Primary Nursery Area: No
(F) Water Classification: SA Open to Shellfishing: No
8. PROJECT SUMMARY: The applicants propose to construct a replacement vinyl
bulkhead waterward of an existing wooden bulkhead, backfill an area of coastal
wetlands, construct a wooden dock overhanging a portion of the bulkhead, and set 3
new mooring piles.
Project Setting
The site of the proposed development is 51170 (Lot 26) and 51172 (Lot 27) Lassiter Lane,
in the Wind-Haven subdivision, Frisco, Dare County on a man-made canal off of the
Pamlico Sound. Each lot is 10,020 sq feet in size. There is an existing single family
residence, driveway and private septic system on Lot 26 and a greenhouse on Lot 27. The
yards of both lots are lawn with scattered trees and shrubs. The upland area is
approximately 4.5 feet above the NWL.
The shoreline of the two lots is approximately 167 feet (82.5 feet per lot) long and is
currently bulkheaded along the full length. The existing wooden bulkhead is deteriorating at
the bottom with a few places where settling has occurred behind the structure. There is an
existing dock of approximately 440 sq ft along a portion of the shoreline.-, There is an
isolated patch (approximately 120 sq ft) of Coastal Wetlands, composed., entirely of Smooth
Cordgrass (Spartina alterniflora) in front of one section of the existing bulkhead/dock.
There are two mooring piles approximately 15 feet channelward of the existing
bulkhead/dock.
The adjacent properties are of similar use and are bulkheaded, as well as the entire
northern side of the canal.
The width of the canal at the project site is approximately 82 feet. No submerged aquatic
vegetation (SAV) was observed within the canal. The water depths along this portion of the
canal are approximately 2.5 ft. The waters of the Pamlico Sound in this area are classified
as SA (shellfish area) but are closed to shellfish harvesting within the canal.
Development Proposal
The applicants propose to construct a 167' long replacement bulkhead of vinyl 2 ft
waterward of the existing bulkhead. A 137' x 4' dock is to be constructed over the new
bulkhead and to extend 2 ft channelward. Three new mooring piles are also proposed.
Anticipated Impacts
¦ The construction of the replacement bulkhead will result in the filling of 60 sq ft of Coastal
Wetlands and 274 sq ft of shallow water habitat (Estuarine Water/Public Trust Area AECs).
• Field Investigation Report
Jacques - Frisco, Dare County
Page 3
¦ The 2 ft extension of the dock over the water will result in shading of 60 sq ft of Coastal
Wetlands and 274 sq ft of shallow water habitat (Estuarine Water/Public Trust Area AECs).
¦ The bulkhead replacement will result in disturbance of approximately 3,340 sq ft of
Estuarine Shoreline AEC.
¦ The bulkhead construction and the installation of the 3 mooring piles will result in a
temporary increase in turbidity in the canal.
¦ There are no known archaeological resources in the area of the project based on a review
of available maps.
Submitted by: Claudia Jones
Date: 5/11/09
for Windsor M. Jacques
CAMAvMaior Permit Apolicadon
Project Location: 51170 & 51172 Lassiter Lane / Lots 26 and 27, Wind-Haven Shores,
Frisco, N.C., 27936, adjacent to a man-made canal contiguous to the Pamlico Sound.
Existing Property Use: The properties are currently zoned residential and only lot 26 is
developed. This property is not in a rental program and is used as a private personal
residence.
Existing Property Characteristics: Each lot contains 10,020 sq ft or 0.23 acres of total
platted lot area. '
Upland Area: The upland area of both lots are stabilized by lawn and shrubs. There is an
existing single family residence on lot 26 with private septic system; and lot 27 is
undeveloped.
Shoreline Area: Lot 26 has 1671.f. of existing wood bulkhead; 501.f. marginal dock; and
two mooring piles. There is approximately 120 sq ft of coastal wetlands adjacent to the
bulkhead on lot 26 at the north end. Lot 27 has an existing wood bulkhead and there are
no wetlands adjacent to this bulkhead. The existing wood bulkhead is deteriorating at and
above the mud line and backfill material is settling down behind the wall.
Proposed Project Description and Lupacts: The proposed project involves the
following: Construction of approximately 1671.f. of vinyl bulkhead, with a 10' return wall
at each end; A 4' x 1371.f. marginal wood dock, (only 2` of the new dock will extend
channel ward of the new bulkhead); and set three mooring piles. The new bulkhead is
proposed to be constructed two feet in front of the existing wood bulkhead and backfilled.
The proposed bulkhead will permanently displace approximately 60 sq ft of coastal
wetlands on lot 26.
Purpose of Project: Bulkhead - The purpose of the project is to replace an existing
deteriorating wood bulkhead. The new bulkhead will help maintain and improve erosion
control; and storm and flood protection for the exsiting upland areas, residence and septic
system; and eliminate a potential source of sedimentation that could have negative water
quality impacts on the adjacent estuarine waters.
Dock and Mooring Piles- The purpose of the dock and mooring piles are to provide
temporary safe mooring and access to the Pamlico Sound.
Construction Methods and Sequence: Methods - Mechanical and manual labor;
Sequence - Construct bulkhead and backfill; Construct dock and set mooring piles; and
seed and mulch all disturbed areas.
09-0607
MPUUTI®N for
Major Derelopmeet Permit "` ' '? 1 `
- - •rw ?rvL !d?Y--l ?S1?Zi?iti'i i
(last nwlsad 1207M) r11?C7 `` Yf. .i
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Infon»ation
Business Name
NA Project Name (if applicable)
AIM
Applicant 1: First Name
WAIDSDR- MI
Al. Last Name
-7,4CQUES
Applicant 2: First Name MI Last Name
if additional applicants, please attach an additional page(s) with names listed.
Mailing Address PO Box
/02S City
&JV,'0 V State
NC
ZIP
Z79ZD Country
DACE Phone No.
25Z - 993 3760 ext. FAX No.
- -
Street Address (if different from above)
S//70 ZA.UMER LANE City
FR/SD State
NC ZIP
27936
Email
2. Agent/Contractor Information
Business Name
Agent/ Contractor 1: First Name
so,Qy MI
M. Last Name
PR/CE
Agent/ Contractor 2: First Name MI Last Name
Mailing Address PO Box
55/ City State
AVON NC
ZIP
2 79/S Phone No. 1
ZSZ - 3OS - 63y 9 ext. Phone No. 2
- - ext.
FAX No.
Z52.995,--3SyY Contractor #
Street Address (d different from above) City State ZIP
Email

<Fonn continues on back>

Form DCM MP-1 (Page 2 of 4) APPLICATION for
Major Development Permit
Y
3. Project Location - °,_ ' "" ,
County (can be multiple) Street Address State Rd. #
We _57/70 le S_// 92 ZAES/TER LAME
Subdivision Name City State Zip
WIND •UL!(/EN SZIA ES L0 NC 27936
Phone No. Lot No.(s) (rfmarry, attach additional page with list)
25Z - 99S -3760 ext. Zro I Z'/ I ,
a. In which NC river basin is the project located? b. Name of body of water nearest to proposed project
1-74SG>UDTL7NK AWIMICO SOUND
c. Is the water body identified in (b) above, natural or manmade?
l [] d. Name the closest major water body to the proposed project site.
&3Natura
Manmade []unknown 54WACD _WND
e. Is p posed work within city limits or planning jurisdiction? f. If applicable, list the planning jurisdiction or city limit the proposed
LbYes ?No work falls within.
0WE CX(/ rY
4. Site Description
a. Total length of shoreline on the tract (ft.) b. Size of entire tract (scift)
/67 ZDJD(/D
c. Size of individual lot(s) d. Approximate elevation of tract above NHW (normal high water) or
/a ¢Z0 I NWL (normal water level) q'5'
(If many lot sizes, please attach additional page with a list) ?NHW or 007 WL
e. Vegetation on tract
Z,,dN/N d AM UL .SAIRI S
f. Man-made features and uses now on tract
RES/Df a
g. Identify and describe the existing land uses adiacent to the proposed project site.
1461'DNT RESAD 7144 LDTS
h. How does local government zone the tract? L Is the proposed project consistent with the applicable zoning?
(Attach zoning compliance certificate, if applicable)

RES/?T?af'
res ?No ?NA
l3
j. Is the proposed activity part of an urban waterfront redevelopment proposal? []Yes &?o
k. Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. []Yes []No
If yes, by whom?
1. Is the proposed project located in a National Registered Historic District or does it involve a []Yes o ?NA
National Register listed or eligible property?
<For n continues on next page>
Form DCM MP-1 (Page 3 of 4)
APPLICATION for
_n ! , la ry Major Development Permit
m. (i) Are there wetlands on the site? t '?I es ?No
(ii) Are there coastal wetlands on the site? Mies ?No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? (<es ?No
(Attach documentation, ifavai?abie) 2bN /ZONJID!
n. Describe existing wastewater treatment facilities.
PR/YD TE SEPT/C
o. Describe existing drinking water supply source.
COUNTY
p. Describe existing storm water management or treatment systems.
MME
5. Acdyitles and Impacts
a. Will the project be for commercial, public, or private use? ?Commercial ?Public/Govemment
[}, rivate/Community
b. Give a brief description of purpose, use, and daily operations of the project when complete.
SM.WEAD - E/ZOS/owp .Szmm inoxi COL .0 FWO A&MECTMI
DOCK - AlflydTE' i1WRIN6
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
/YIECI/401111 L CeNAV1114L 14&X
BDC,C wE e Dilly mart
d. List all development activities you propose.
CDNSMY r &/1WIX D, OX16 EK7EN51,Oi1 OAJD SET MOVING RIMS
e. Are the proposed activities maintenance of an existing project, new work, or both?
BD)W
f. What is the approximate total disturbed land area resulting from the proposed project? VfSq.Ft or ?Acres
/jwl"70
g. Will the proposed project encroach on any public easement, public accessway or other area ?Yes No ?NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
SM?F41E WOMC /PUMOIF
I. Will wastewater or stormwater be discharged into a wetland? ?Yes o ?NA
If yes, will this discharged water be of the same salinity as the receiving water? ?Yes ?No ?NA
j. Is there any mitigation proposed? ?Yes o ?NA
If yes, attach a mitigation proposal.
<Form continues on back>
,Form DCM MP-1 (Page 4 of 4)
=jiZOL 7r
APPLICATION for
Major Development Permit
6. Addidonallnformadon
in addition to this completed application firm, (MP-1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) - (q are always applicable to any major development application. Please consult the application
Instruction booklet on how to property prepare the required items below
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name AAWLP C, W'4"Lvi 1? Phone No.
Address 3933 INDMAI RIAU RD, Y4. ,BEACH, M-j 2351SZo
Name /HAZY F CLOWRY, J711SW Phone No.
Address 7SDy IW AZE' 76" Wl'E, HWJW1 r.D.Q, !N/ i S32 / 3
Name Phone No.
Address
g. A list of previous s to or federal permits issued for work on the project tract Include permit numbers, permittee, and issuing dates.
OPA?/21? - C120ES_ 31Z3i 9a
GoA 7-V7 - 7718E 1///1/90
6AO 6967 - MAY - .s/14619D
MP 017 - %1_?qCaUL!1 /J94-
h. Signed consultant or agent authorization form, if applicable.
I. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S.113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
7. Cerdflcation and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date Og1011D9 Print Name G WY PRIG
Signature zlt? tcQn-- ?
se indicate application attachments pertaining to your proposed project.
Pie W se
MP-2 Excavation and Fill Information ?DCM MP-5 Bridges and Culverts
?DCM MP-3 Upland Development
eDCM MP-4 Structures Information

Form DCM MP-2
EXCAVATION and FILL
(Except for bridges and culverts)

Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet.
Access Other
Channel Canal Boat Basin Boat Ramp Rock Groin Rock (excluding
(NLW or Breakwater shoreline
NWL stabilization
Length
Width
Avg. Existing
NA
NA
Depth
Final Project NA NA
Depth
1. EXCAVATION R-Ais section not applcable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlands/marsh d. High-ground excavation in cubic yards.
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
?CW ?SAV ?SS
?WL ?None
(ii) Describe the purpose of the excavation in these areas:
2. DISPOSAL OF EXCAVATED MATERIAL s section not applicable
a. Location of disposal area. b. Dimensions of disposal area.
c. (i) Do you claim title to disposal area? d. (i) Will a disposal area be available for future maintenance?
?Yes ?No ?NA ?Yes ?No ?NA
(ii) If no, attach a letter granting permission from the owner. (ii) If yes, where?
e. (i) Does the disposal area include any coastal wetlands/marsh f. () Does the disposal include any area in the water?
(CW), submerged aquatic vegetation (SAV), shell bottom (SB), ?Yes ?No ?NA
or other wetlands (WL)? If any boxes are checked, provide the (ii) yes how much water area is affected?
()'
number of square feet affected.
?CW ?SAV ?SB
?WL ?None
(ii) Describe the purpose of disposal in these areas:

J.
3. SHORELINE STABILIZATION I m0c-th C i `This section not applicable
(N development is a wood groin, use MP-4 - Structures)
a. Type of shoreline stabilization: b. Length:
Bulkhead ?Riprap OBreakwater/Sill DOther.------- - Width: Q,8
c. Average distance waterward of NHW or NWL: d. Maximum distance waterward of NHW or NWL:
Ze Z'
e. Type of stabilization material:
VINYL
g. Number of square feet of fill to be placed below water level.
Bulkhead backfiil 339 Riprap
Breakwater/Sill Other
i. Source of fill material.
UPWAID JDCF.SITE
f. (i) Has there been shoreline erosion during preceding 12
months?
OYes j!fN/o ONA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
EJAID
4, OTHER FILL ACTIVITIES his section not applicable
(Excluding Shoreline Srabiirafion)
a. (i) Will fill material be brought to the site? OYes ?No ONA b. (1) Will fill material be placed in coastal wetlands/marsh (CW),
If yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
submerged aquatic vegetation ($AV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
OCW OSAV OSB
OWL ONone
(ii) Describe the purpose of the fill in these areas:
5. GENERAL
a. How will excavated or fill material be kept on site and erosion b. What type of construction equipment will be used (e.g., drogiine,
controlled? backhoe, or hydraulic dredge)?
BULIe,UEAD ,eGRASS &Ckkaf I'&WIP MCK
C. (i) Will naviga ' nal aids be required as a result of the project?
[]Yes QNo ONA
(ii) If yes, explain what type and how they will be implemented.
d. (i) Will wetlands be cpssed in transporting equipment to project
site? []Yes [0611o ONA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
w/ND&OZ M. -T44WES
Date Applicant Name
Project Name Applicant Signature

Form DCM MP-4
STRUCTURES a3 p 3'
(Construction within Public Trust Areas) FLiJadc.xJ li /
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. DOCKING FACILITY/MAR/NA CHARACTERIS77CS
a. (i) Is the docking facility/marina:
[]Commercial ?Public/Govemment []Private/Community
c. (i) Dock(s) and/or pier(s)
(ii) Number
(iii) Length /37
(iv) Width V
(v) Floating []Yes [,C
No
e. (i) Are Platforms included? []Yes 2?1
If yes:
(ii) Number
(iii) Length
(iv) Width
(v) Floating []Yes ?No
Note: Roofed areas are calculated from dripline dimensions.
g. (i) Number of slips proposed
2
(ii) Number of slips existing
-I
i. Check the proposed type of siting:
? Land cut and access channel
[]Open water, dredging for basin and/or channel
&6pen water, no dredging required
[]Other; please describe:
i
k. Typical boat length:
m. (i) Will the facility have tie pilings?
[Kes ?No
(ii) If yes number of tie pilings?
3
[]This section not applicable
b. Q) Will the facility be open to the general public?
[]Yes EfNo
d. (i) Are Finger Piers included? []Yes Elho
If yes:
(ii) Number
(iii) Length
(iv) Width
(v) Floating []Yes ?No
f. (i) Are Boatlifts included? []Yes EJ-N'o
If yes:
(ii) Number
(iii) Length
(iv) Width
h. Check all the types of services to be provided.
? Full service, including travel lift and/or rail, repair or
maintenance service
? Dockage, fuel, and marine supplies
[] Dockage (beet slips') only, number of slips:
? Dry storage; number of boats:
? Boat ramp(s); number of boat ramps:
? Other, please describe:
j. Describe the typical boats to be served (e.g., open runabout,
charter boats, sail boats, mixed types).
OPEN MNABOUT
1. (i) Will the facility a open to the general public?
[]Yes lo
r
jr
2. DOCKING FACIU MMARINA OPERATIONS This sedion not applicable
a. Check each of the following sanitary facilities that will be Included in the proposed project.
? Office Toilets
? Toilets for patrons; Number: ; Location:
3 A?
? Showers
Boatholdin tank ? ? ? J
? g pumpout; Give type and location: -
e;h
b. Describe treatment type and disposal location for all sanitary wastewater.
c. Describe the disposal of solid waste, fish offal and trash.
d. How will overboard discharge of sewage from boats be controlled?
e. (i) Give the location and number of "No Sewage Discharge" signs proposed.
(ii) Give the location and number of "Pumpout Available" signs proposed.
f. Describe the special design, if applicable, for containing industrial type pollutants, such as paint, sandblasting waste and petroleum products.
g. Where will residue from vessel maintenance be disposed of?
h. Give the number of channel markers and "No Wake" signs proposed.
i. Give the location of fuel-handling facilities, and describe the safety measures planned to protect area water quality.
j. What will be the marina policy on overnight and live-aboard dockage?
k. Describe design measures that promote boat basin flushing?
1. If this project is an expansion of an existing marina, what types of services are currently provided?

91
m. Is the marina/docking facility proposed within a primary or secondary nursery area?
[]Yes []No b J , a 4
fijj ^ lc V,
n. Is the marina/docking facility proposed within or adjacent to any shellfish harvesting area? Crbet 3 t.i)
?Yes ?No
o. Is the marina/docking facility proposed within or adjacent to coastal wetlands/marsh (CW), submerged aquatic vegetation (SAV), shell bottom
(SB), or other wetlands (WL)? If any boxes are checked, provide the number of square feet affected.
?CW ?SAV ?SB
[]WL []None
p. Is the proposed marina/docking facility located within or within close proximity to any shellfish leases? ?Yes ?No
If yes, give the name and address of the leaseholder(s), and give the proximity to the lease.
3. BOATHOUSE (including covered lifts} [Rfhis section not applicable
a. (t) Is the boathouse stricture(s):
[]Commercial []Public/Govemment []Private/Community
(5) Number
(iii) Length
(iv) Width
Note: Roofed areas are calculated from dripline dimensions.
4. GROIN (e.g., wood, sheetpile, etc. If a rock groin, use MP-2, Excavation and FIN.) EKhis section not applicable
a. (i) Number
(ii) Length
(iii) Width
3. BREAKWATER (e.g., wood, sheetpile, etc.) his section not applicable
a. Length b. Average distance from NHW, NWL, or wetlands
c. Maximum distance beyond NHW, NWL or wettands
6. MOORING PILINGS and BUOYS []This section not applicable I
a. is the stricture(s):
[]Commercial []Publiic/Govemment E rivate/Community
c. Distance to be placed beyond shoreline 15",
Note: This should be measured from marsh edge, if present.
b. Number 3
d. Description of buoy (color, inscription, size, anchor, etc.)
A114
e. Arc of the swing yld
-z
7. GENERAL
a. Proximity of structure(s) to adjacent riparian property lines
/P
Note: For buoy or mooring piling, use arc of swing including length
of vessel.
ry5 1
b. Proximity of structure(s) to adjacent docking faalitie`s. } '
/Yra
c. Width of water body
92".t
e. (i) Will navigational aids be required as a result of the project?
?Yes [jlo ?NA
(ii) If yes, explain what type and how they will be implemented.
d. Water depth at waterward end of structure at NLW or NWL
Z -1. 5 _-1
S. OTHER his section not applicable
a. Give complete description:
Dy-O/- D 9
Date
Project Name
W141XI M J%JMIES
Applicant Name
?W
Applicant Sign ure
MAJOR PERMIT FEE MATRIX
Applicant: WINDSOR M. JACQUES
Selection Development Type Fee DCM % DWQ %
(14300 1601 435100093 1625 6253) (24300 1602 435100095 2341)
1. Private, non-commercial
development that does not $250 100%($250) 0%($0)
involve the filling or
excavation of any wetlands
or open water areas:
II. Public or commercial
E] development that does not $400 100%($400) 0%($0)
involve the filling or
excavation of any wetlands
or open water areas:
III. For development that
involves the filling and/or
excavation of up to 1 acre
of wetlands and/or open
water areas, determine if A,
B, C, or D below applies:
III(A). Private, non-
commercial development, if $250 100%($250) 0%($0)
General Water Quality
Certification No. 3490 (See
attached can be applied:
III(B). Public or commercial
development, if General $400 100%($400) 0%($0)
Water Quality Certification
No. 3490 (See attached)
can be applied:
III(C). If General Water
? Quality Certification No. $400 60%($240) 40%($160)
3490 (see attached) could
be applied, but DCM staff
determined that additional
review and written DWQ
concurrence is needed
because of concerns
related to water quality or
aquatic life:
III(D). If General Water
PL-M Quality Certification No. $400 60%($240) 40%($160)
3490 (see attached) cannot
be applied:
IV. For development that
? involves the filling and/or $475 60%($285) 40%($190)
excavation of more than
one acre of wetlands and/or
open water areas:

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