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<br />10
<br />
<br />Instructions for
<br />Preparing an Application
<br />
<br />The instructions given below, together with
<br />the sample application and drawings, should
<br />help in completing the required application
<br />form. If you have additional questions, do
<br />not hesitate to contact the district regulatory
<br />office.
<br />
<br />Block Number 1. Application Number.
<br />Leave this block blank. When your com-
<br />pleted application is received, it will be
<br />assigned a number for identification. You
<br />will be notified of the number in an acknowl-
<br />edgement letter. Please refer to this number
<br />in any correspondence or inquiry concern-
<br />ing your application.
<br />
<br />Block 2. Name and address of
<br />applicant(s). Fill in name, mailing address,
<br />and telephone number(s) for all applicants.
<br />The telephone number(s) should be a num-
<br />ber where you can be reached during busi-
<br />ness hours. If space is needed for additional
<br />names, attach a sheet of white, 81/2 x 11
<br />inch paper labeled "Block 2 Continued."
<br />
<br />Block 3. Name, address and title of auth-
<br />orized agent. It is not necessary to have an
<br />agent represent you; however, if you do, fill
<br />in the agent's name, address, title and tele-
<br />phone number(s). If your agent is submitting
<br />and signing the application, you must fill out
<br />and sign the Statement of Authorization in
<br />Block 3.
<br />
<br />Block 4. Detailed description of proposed
<br />activity. The written description and the
<br />drawings are the most important parts of the
<br />application. If there is not enough space in
<br />Block 4, (a), (b) or (c) attach additional
<br />sheet(s) of white, 81/2 x 11 inch paper
<br />labeled "Block 4 Continued."
<br />
<br />a. Activity. Describe the overall activity.
<br />Give the approximate dimensions of
<br />structures, fills, excavations (lengths,
<br />widths, heights or depths).
<br />
<br />b. Purpose. Describe the purpose, need
<br />and intended use (public, private, com-
<br />mercial, or other use) of the proposed
<br />activity. Include a description of related
<br />facilities, if any, to be constructed on
<br />adjacent land. Give the date you plan to
<br />begin work on the activity and the date
<br />work is expected to be completed.
<br />
<br />c. Discharge of Dredged or Fill Material.
<br />If the activity will involve the discharge
<br />of dredged or fill material, describe the
<br />type (rock, sand, dirt, rubble, etc.), quan-
<br />tity (in cubic yards), and mode of trans-
<br />portation to the discharge site.
<br />
<br />Block 5. Names and addresses of adJoin-
<br />ing property owners, lessees, etc. whose
<br />property adjoins the waterbody. List com-
<br />plete names, addresses and zip codes of
<br />adjacent properly owners (both public and
<br />private), lessee, etc., whose properly also
<br />adjoins the waterbody or wetland, in order
<br />that they may be notified of the proposed
<br />activity. This information is usually available
<br />at the local tax assessor office. If more
<br />space is needed attach a sheet of white,
<br />81/2 x 11 inch paper labeled "Block 5
<br />Continued."
<br />
<br />Block 6. Waterbody and location on
<br />waterbody where activity exists or Is pro-
<br />posed. Fill in the name of the waterbody
<br />and the river mile (if known) at the location
<br />of the activity. Include easily recognizable
<br />landmarks on the shore of the waterbody to
<br />aid in locating the site of the activity.
<br />
<br />Block 7. Location and land where activity
<br />exists or Is proposed. This information is
<br />used to locate the site. Give the street
<br />address of the properly where the proposed
<br />activity will take place. If the site does not
<br />have a street address, give the best descrip-
<br />tive location (name or waterbody), names
<br />and/or numbers of roads or highways, name
<br />of nearest community or town, name of
<br />county and state, and directions, such as 2
<br />miles east of Brown's Store on Route 105.
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