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REQUEST FOR AQUATIC RESOURCES DELINEATION VERIFICATION <br /> OR JURISDICTIONAL DETERMINATION <br /> A separate jurisdictional determination (JD)is not necessary to process a permit.An Approved Jurisdictional Determination (AJD)is <br /> required to definitively determine the extent of waters of the U.S. and is generally used to disclaim jurisdiction over aquatic resources <br /> that are not waters of the U.S., in cases where the review area contains no aquatic resources, and in cases when the recipient wishes <br /> to challenge the water of the U.S. determination on appeal. Either an Aquatic Resources Delineation Verification or a Preliminary <br /> Jurisdictional Determination (PJD)may be used when the recipient wishes to assume that aquatic resources are waters of the U.S.for <br /> the purposes of permitting. In some circumstances an AJD may require more information, a greater level of effort, and more time to <br /> produce. If you are unsure which product to request, please speak with your project manager or call the Sacramento District's general <br /> information line at(916)557-5250. <br /> 1 am requesting the product indicated below from the U S.Army Corps of Engineers, Sacramento District, for the review area located at <br /> Street Address 35405 State Highway 9 City. none County summit <br /> State. co Zip: Section 19&20 Township. 3 Range: 78West <br /> Latitude(decimal degrees):39775211- Longitude(decimal degrees) 106154839 <br /> The approximate size of the review area for the JD is 78 acres. (Please attach location map) <br /> Choose one Choose one product: <br /> ®1 own the review area Q I am requesting an Aquatic Resources Delineation Verification <br /> ®1 hold an easement or development rights over the review area 01 am requesting an Approved JD <br /> ©1 lease the review area 01 am requesting a Preliminary JD <br /> ®1 plan to purchase the review area 01 am requesting additional information to inform my decision <br /> 0 1 am an agent/consultant acting on behalf of the requestor about which product to request <br /> ®Other: <br /> Reason for request: (check all that apply) <br /> ✓❑I need information concerning aquatic resources within the review area for planning purposes. <br /> ❑I intend to construct/develop a project or perform activities in this review area which would be designed to avoid all aquatic <br /> resources. <br /> 0 <br /> 1 intend to construct/develop a project or perform activities in this review area which would be designed to avoid those aquatic <br /> resources determined to be waters of the U.S. <br /> El intend to construct/develop a project or perform activities in this review area which may require authorization from the Corps;this <br /> request is accompanied by my permit application. <br /> ❑I intend to construct/develop a project or perform activities in a navigable water of the U.S.which is included on the district's list of <br /> navigable waters under Section 10 of the Rivers and Harbors Act of 1899 and/or is subject to the ebb and flow of the tide. <br /> ❑My lender, insurer, investors, local unit of government, etc. has indicated that an aquatic resources delineation verification is <br /> inadequate and is requiring a jurisdictional determination. <br /> ❑1 intend to contest jurisdiction over particular aquatic resources and request the Corps confirm that these aquatic resources are or <br /> are not waters of the U.S. <br /> ❑l believe that the review area may be comprised entirely of dry land. <br /> ❑Other <br /> Attached Information: <br /> ❑Maps depicting the general location and aquatic resources within the review area consistent with Map and Drawing Standards for <br /> the South Pacific Division Regulatory Program (Public Notice February 2016, <br /> http//www.spd.usace army mil/Missions/Regulatory/Public-Notices-and-References/Article/651327/updated-map-and-drawing- <br /> standards/) <br /> ✓❑Aquatic Resources Delineation Report, if available, consistent with the Sacramento District's Minimum Standards for Acceptance <br /> Public Notice January 2016, htt //I.usa.gov/lV68IYa) <br /> By signing below, you are indicating that you have the authority, or are acting as the duly authorized agent of a person or entity with <br /> such authority,to and do hereby grant Corps personnel right of entry to legally access the review area. Your signature shall be an <br /> affirmation that you possess the requisite property rights for this request on the subject property. <br /> *Signature: � '7�' <br /> /` Date 1/20/21 <br /> Name: DavldJ Blauch Company name Ecological Resource Consultants,Inc <br /> Address' 2820 Wilderness Place,Suite A <br /> Boulder,Colorado 80301 <br /> Telephone: 303-679-4820 Email:dave@erccolorado net <br /> `Authorities:Rivers and Harbors Act,Section 10,33 USC 403,Clean Water Act,Section 404,33 USC 1344,Manne Protection,Research,and Sanctuaries Act,Section 103,33 USC 1413,Regulatory <br /> Program of the U S Army Corps of Engineers,Final Rule for 33 CFR Parts 320-332 <br /> Principal Purpose:The information that you provide will be used in evaluating your request to determine whether there are any aquatic resources within the project area subject to federal jurisdiction <br /> under the regulatory authorities referenced above <br /> Routine Uses:This information may be shared with the Department of Justice and other federal,state,and local government agencies,and the public,and may be made available as part of a public <br /> notice as required by federal law Your name and property location where federal jurisdiction is to be determined will be included in the approved jurisdictional determination(AJD),which will be made <br /> available to the public on the District's website and on the Headquarters USACE website <br /> Disclosure:Submission of requested information is voluntary,however,if information is not provided,the request for an AJD cannot be evaluated nor can an AJD be issued <br />