ࡱ>   @ h0bjbj H؝؝T ,,, d Ŭf4ILLILILIMdOl|O8Чҧҧҧҧҧҧ$+R}N`M^lM@``LILIܮܮܮ`&8LILIЧܮ`Чܮܮu LI HAQ,>z&<ԑ0ŬD˱db˱xl ˱PT~ܮvXB[OLP P $ d(wƮ (U.S. ARMY CORPS OF ENGINEERS (USACE)MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY (MDEQ)Detroit District OfficeLand and Water Management Division (LWMD)Phone: 313-226-2218, Fax: 313-226-6763Phone: 517-373-9244, Fax: 517-241-9003Website:  HYPERLINK "http://www.lre.usace.army.mil" www.lre.usace.army.milWebsite:  HYPERLINK "http://www.michigan.gov/deq" www.michigan.gov/deq The MDEQ, LWMD, regulates activities under the following Parts of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended. The regulated activities are summarized in Appendix D. The complete statutes and rules can be downloaded from our website at  HYPERLINK "http://www.michigan.gov/jointpermit" www.michigan.gov/jointpermit.Part 301, Inland Lakes and StreamsPart 353, Sand Dunes Protection and ManagementPart 303, Wetlands ProtectionPart 323, Shorelands Protection and ManagementPart 325, Great Lakes Submerged LandsPart 315, Dam SafetyFloodplain Regulatory Authority found in Part 31, Water Resources Protection The USACE has the authority to regulate activities within the waters of the United States under the following statutes:Section 10, Rivers and Harbors Act of 1899 (33 U.S.C. 403)Section 404, Clean Water Act of 1977 (33 U.S.C. 1344)  Before you apply, consider an Optional LWMD Pre-application Meeting for files regulated under Parts 301 and 303 available for a fee or in some cases free. For more information go to our website at  HYPERLINK "http://www.michigan.gov/jpintpermit" www.michigan.gov/jointpermit DIRECTIONS for completing the Joint Permit Application For additional guidance go to the Joint Permit Application Training Manual link or EZ Guides for small projects designed for the average home owner on our website at  HYPERLINK "http://www.michigan.gov/jointpermit" www.michigan.gov/jointpermit. Complete all items in Sections 1 through 9 on pages 1 and 2 of the application: Make sure you: Provide the Township, Range, Section, and Property Tax Identification Numbers required in Section 1. Provide the requested information for all adjacent and impacted property owners in Section 8. Print your name and sign and date your application in Section 9. If applicant is a corporation, include title of authorized representative. Provide a letter of authorization if the legal property owner is not the individual who signs the application. A letter of authorization is a letter from the legal landowner(s) authorizing the applicant or agent to apply for the project. The letter should include the signature from the landowner, the project site address, and a brief project description. Complete project-specific information: Complete items in Sections 10 through 21 on pages 3 through 7 that apply to your project. Follow the instructions at the beginning of each section. The instructions for each sample drawing in Appendix B indicate the application sections you will most likely need to complete. Utilize the application form as much as possible before adding attachments to save on paper resources and to make the review more efficient. Provide maps and drawings with adequate detail for review. Refer to Appendix B of the application and/or  HYPERLINK "http://www.michigan.gov/jointpermit" www.michigan.gov/jointpermit for sample drawings. Vicinity Map: A map to the proposed project location that includes ALL streets, roads, intersections, highways, or cross-roads to the project. Include written directions from a well-known landmark or major intersection. Do not assume field staff knows where your project is. Project Site Plan: Overhead drawings to scale or including dimensions, length and width, of the proposed project are required. Section Views (cross and profile to scale or including dimensions, length, width, and height): Cross sectional drawings of the proposed projects are required. Provide descriptive photographs of the proposed work site showing vegetation if wetlands are involved or the shoreline for shore protection projects. All photographs must be labeled with your name and the date of the photograph, indicate what they show, and be referenced to the site plan. Proposed activities or structure(s) may be indicated directly on the photographs using indelible markers or ink pens. Provide aerial photographs 1:400 or larger for major projects. Provide a reproducible version of maps and drawings if the originals are supplied in color. Elevation data must include a description of the reference point or benchmark used and its corresponding elevation. For projects on the Great Lakes or Section 10 Waters, elevations must be provided in IGLD 85. For observed Great Lake water elevations in IGLD, visit the USACE website under water levels. If elevations are from still water, provide the observation date and water elevation. On inland sites, elevations can use NAVD 88, NGVD 29, a local datum or an assumed bench mark. The state building code requires an Elevation Certificate for any building construction or addition in the floodplain. A sample form can be found at  HYPERLINK "http://www.fema.gov/nfip/elvinst.shtm" www.fema.gov/nfip/elvinst.shtm Flagging/staking project sites and project impacts: Flag the area for site inspection including the property corners, proposed road or driveway centerlines, and areas of proposed impacts. Site must be flagged at the time the application is submitted. A site visit will not be completed or action taken if the project is not flagged. To prevent processing delays, make sure all the following items are mailed to the LWMD at the address below, label each attachment with applicant's name and date: Pages 1 and 2 of the application. Pages 3 through 7, as applicable, of the application. Do not submit blank application pages. Submit only those pages where you have provided information. The Site Location Map, Overall Site Plan, Plan View and Cross-Section Drawings, Photographs, and additional information sheets on 8.5 x 11, 8.5 x 14, or 11 x 17 paper suitable for photocopying for public notice purposes. Aerial photographs do not substitute for site plans. If larger drawings or blueprints are required to show adequate detail for review, you may also submit 2 full size copies. The USACE requires one set of drawings on 8.5 x 11 paper, with all notations clearly legible. Larger supplemental drawings may be submitted, as well. An authorization letter from the property owner if someone other than the property owner is signing the application. A check made payable to the State of Michigan. Fees typically range from $50.00 to $4,000.00 depending on the type of project. Refer to Appendix C of the application and/or visit our website HYPERLINK "http://www.michigan.gov/jointpermit"  at  HYPERLINK "http://www.michigan.gov/jointpermit" http://www.michigan.gov/jointpermit to determine the appropriate fee for your project and to download a form for credit card or electronic transfer payment. Mail to: MDEQ LWMD-PCU P.O. BOX 30204 LANSING, MI 48909-7704  HYPERLINK "mailto:DEQ-LWM-PCU@michigan.gov" DEQ-LWM-PCU@michigan.gov Public Agencies eligible to receive federal and/or state transportation funding for a project involving public roadways, non-motorized paths, airports, or related facilities, do not require an application fee and should submit applications to: MDEQ LWMD-TFHU P.O. Box 30458 Lansing, MI 48909-7958 Appendices Appendix A: Acronyms and Abbreviations A-1 Appendix B: General Instructions for All Drawings and Sample Drawings General Instructions for all Drawings and Sample Site Location Maps B-1 Inland Lake Shore Protection B-2 Bulkhead/Seawall B-2 Pond Construction B-3 Floodplain Fill B-3 Wetland Boardwalk B-4 Dredging Project B-4 Driveway Across Wetland B-5 Residential Wetland Fill and Boardwalk Construction B-5 Docks - Piers - Mooring Piles B-6 Beach Sanding B-6 Pipe/Utility Crossings in a Trench B-7 Pipe/Utility Crossings using Directional Bore B-7 Bridge or Culvert (4 drawings) B-8 Dam Construction B-12 Water Intake B-12 Great Lakes Shore Protection B-13 Maintenance Dredge Channel B-13 Proposed Residence in a High Risk Erosion Area B-14 Proposed Residence in a Critical Dune Area B-14 Marina Site Plan B-15 Outlet Pipe B-16 Temporary Logging Road Crossing B-16 Appendix C: State Fees, Federal Fees, Minor Permit and General Permit for Minor Activities Categories C-1 Appendix D: State Authority, Federal Authority, Privacy Act Statement, and State and Federal Penalties D-1 Appendix E: Glossary (listed words are italicized in the application package) E-1 Application status can be viewed on the MDEQ website at  HYPERLINK "http://www.deq.state.mi.us/CIWPIS" www.deq.state.mi.us/CIWPIS. During the application period, if any information is missing from the application or if any clarification is needed regarding materials provided, the application is incomplete and MDEQ staff will request the information from the applicant/agent by letter, email, fax or phone call. Once the MDEQ/LWMD has received the information necessary for review of the project, including a thoroughly completed application, consistent drawings that have adequate detail for review and the full application fee, the file will be reviewed for final processing. A mailed postcard or a public notice will provide the file number and the telephone number of the office where the application is being processed. The review time to determine if an application is complete for processing ranges from 15 to 30 days. Technical processing times, after the application is administratively complete, may range from 60 to 90 days. Processing times will be longer if a public hearing is held. A LWMD staff person from your local District/Field Office may visit the project site and may request additional information prior to a decision on the permit. Application fees are not refundable or transferable. If a federal permit will also be required, a copy of the permit application will be sent to the Detroit District Office, USACE, for processing at the federal level. Additional copies of this application form can be downloaded from the MDEQ website at  HYPERLINK "http://www.michigan.gov/jointpermit" www.michigan.gov/jointpermit or can be photocopied from the original. If you have any questions about the permitting process or if you need to modify your application, you can contact the LWMD by phone, fax, at the addresses on the previous page, or email at  HYPERLINK "mailto:DEQ-LWM-PCU@michigan.gov" DEQ-LWM-PCU@michigan.gov. AGENCY USEPrevious USACE Permit or File NumberDate ReceivedLand and Water Management Division, MDEQ File NumberAGENCY USEUSACE File NumberPre-application Number or Marina Operating Permit NumberDistrict OfficeFee received $Read Instructions pages i - iii. All of the following boxes below must be checked and information provided for the application to be processed:  FORMCHECKBOX  All items in Sections 1 through 9 are completed  FORMCHECKBOX  Date project was staked  FORMTEXT        FORMCHECKBOX  Items in Sections 10 through 21 that apply to the project are completed  FORMCHECKBOX  Application fee is attached  FORMCHECKBOX  Dimensions, volumes and calculations are provided  FORMCHECKBOX  All requested supplementary attachments (() are included  FORMCHECKBOX  Reproducible location map, site plan(s), cross sections and photographs are provided, one set must be black and white on 8 by 11 inch paper.  FORMCHECKBOX  List any additional attachments, tables, etc.:  FORMTEXT       1 PROJECT LOCATION INFORMATION Refer to your property s legal description for the Township, Range, and Section information, and your property tax bill for your Property Tax Identification Number(s).Site location Address (road, if no street address)  FORMTEXT      Zip Code  FORMTEXT      Township Name(s)  FORMTEXT      Township(s)  FORMTEXT      Range(s)  FORMTEXT      Section(s)  FORMTEXT      City/Village  FORMTEXT      County(ies)  FORMTEXT      Property Tax Identification Number(s)  FORMTEXT      Name of Waterbody  FORMTEXT      Project Name or Job Number  FORMTEXT      Subdivision/Plat Lot Number  FORMTEXT        FORMTEXT      Private Claim  FORMTEXT      Project types  FORMCHECKBOX  private  FORMCHECKBOX  public/government  FORMCHECKBOX  industrial  FORMCHECKBOX  commercial  FORMCHECKBOX  multi-family (check all that apply)  FORMCHECKBOX  building addition  FORMCHECKBOX  new building or structure  FORMCHECKBOX  building renovation or restoration  FORMCHECKBOX  river restoration  FORMCHECKBOX  single-family  FORMCHECKBOX  project is receiving federal transportation funds  FORMCHECKBOX  other (explain)  FORMTEXT      The proposed project is on, within, or involves (check all that apply)  FORMCHECKBOX  a legally established County Drain (date established) (M/D/Y)  FORMTEXT      / FORMTEXT      / FORMTEXT        FORMCHECKBOX  a stream  FORMCHECKBOX  a pond (less than 5 acres)  FORMCHECKBOX  a Great Lake or Section 10 Waters  FORMCHECKBOX  a natural river  FORMCHECKBOX  a new marina  FORMCHECKBOX  a river  FORMCHECKBOX  a channel/canal  FORMCHECKBOX  a designated high risk erosion area  FORMCHECKBOX  a dam  FORMCHECKBOX  a structure removal  FORMCHECKBOX  a ditch or drain  FORMCHECKBOX  an inland lake (5 acres or more)  FORMCHECKBOX  a designated critical dune area  FORMCHECKBOX  a wetland  FORMCHECKBOX  a utility crossing  FORMCHECKBOX  a floodway area  FORMCHECKBOX  a 100-year floodplain  FORMCHECKBOX  a designated environmental area  FORMCHECKBOX  500 feet of an existing waterbody 2 DESCRIBE PROPOSED PROJECT AND ASSOCIATED ACTIVITIES, AND THE CONSTRUCTION SEQUENCE AND METHODS (attached additional sheets) Written Summary of All Proposed Activities.  FORMTEXT       Construction Sequence and Methods.  FORMTEXT       3 APPLICANT, AGENT/CONTRACTOR, AND PROPERTY OWNER INFORMATIONOwner/Applicant (individual or corporate name)  FORMTEXT      Agent/Contractor (firm name and contact person)  FORMTEXT      Mailing Address  FORMTEXT      Address  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip Code  FORMTEXT      City  FORMTEXT       State  FORMTEXT       Zip Code  FORMTEXT       Daytime Phone Number with Area Code Cell Phone Number  FORMTEXT      - FORMTEXT      - FORMTEXT        FORMTEXT      - FORMTEXT      - FORMTEXT      Daytime Phone Number with Area Code Cell Phone Number  FORMTEXT      - FORMTEXT      - FORMTEXT        FORMTEXT      - FORMTEXT      - FORMTEXT      Fax  FORMTEXT      - FORMTEXT      - FORMTEXT       E-mail  FORMTEXT      Fax  FORMTEXT      - FORMTEXT      - FORMTEXT       E-mail  FORMTEXT       FORMCHECKBOX  No  FORMCHECKBOX  Yes Is the applicant the sole owner of all property on which this project is to be constructed and all property involved or impacted by this project? ( If no, attach letter(s) of authorization from all owners. A letter signed by each property owner authorizing the agent/contractor/other owner to act on his or her behalf or a copy of easements or rightofways must be provided. If multiple property owners, also attach a list of all owners along with their names, mailing addresses, and telephone numbers. If the applicant is a corporation, a corporate officer must provide written document authorizing any agent/contractor listed above to act on its behalf. A letter of authorization must be provided from an owner receiving dredge spoils on their property, or where access through their property is required..Property Owner s Name (If different from applicant)  FORMTEXT      Mailing Address  FORMTEXT      Daytime Phone Number with Area Code Cell Phone Number  FORMTEXT      - FORMTEXT      - FORMTEXT        FORMTEXT      - FORMTEXT      - FORMTEXT      City State Zip Code  FORMTEXT        FORMTEXT        FORMTEXT       FORMCHECKBOX  No  FORMCHECKBOX  Yes Is there a MDEQ conservation easement or other easement, deed restriction, lease, or other encumbrance upon the property in the project area? ( If yes, attach a copy. 4 PROPOSED PROJECT PURPOSE, INTENDED USE, AND ALTERNATIVES CONSIDERED (Attach additional sheets if necessary) Purpose/Intended Use: The purpose must include any new development or expansion of an existed land use.  FORMTEXT       Alternatives: Include a description of alternatives considered to avoid or minimize resource impacts. Include factors such as, but not limited to, alternative construction technologies; alternative project layout and design; and alternative locations. For utility crossings, include both alternative routes and alternative construction methods.  FORMTEXT       5 LOCATING YOUR PROJECT SITE (Attach a black and white, legible copy of a map that clearly shows the site location and road from the nearest major intersection, and includes a north arrow.Is there an access road to the project?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, type of road, check all that apply)  FORMCHECKBOX  private  FORMCHECKBOX  public  FORMCHECKBOX  improved  FORMCHECKBOX  unimproved Name of roads at closest main intersection  FORMTEXT       and  FORMTEXT       Directions from main intersection  FORMTEXT       Style of house or other building on site  FORMCHECKBOX  ranch  FORMCHECKBOX  2-story  FORMCHECKBOX  cape cod  FORMCHECKBOX  bi-level  FORMCHECKBOX  cottage/cabin  FORMCHECKBOX  pole barn  FORMCHECKBOX  none  FORMCHECKBOX  other (describe)  FORMTEXT       Color  FORMTEXT       Color of adjacent property house and/or buildings  FORMTEXT       House number  FORMTEXT       Street name  FORMTEXT       Fire lane number  FORMTEXT       Lot number  FORMTEXT       Address is visible on  FORMCHECKBOX  house  FORMCHECKBOX  garage  FORMCHECKBOX  mailbox  FORMCHECKBOX  sign  FORMCHECKBOX  other (describe)  FORMTEXT       How can your site be identified if there is no visible address?  FORMTEXT       Provide directions to the project site, with distances from the best and nearest visible landmark and waterbody  FORMTEXT      Does the project cross the boundaries of two or more political jurisdictions? (City/Township, Township/Township, County/County, etc.)  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( If Yes, list jurisdictions:  FORMTEXT        6 List all other federal, interstate, state, or local agency authorizations required for the proposed activity, including all approvals or denials received. Agency Type approval Identification number Date applied Date approved / denied If denied, reason for denial  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       7 COMPLIANCE If a permit is issued, date activity will commence (M/D/Y)  FORMTEXT      / FORMTEXT      / FORMTEXT       Proposed completion date (M/D/Y)  FORMTEXT      / FORMTEXT      / FORMTEXT      Has any construction activity commenced or been completed in a regulated area?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, identify the portion(s) underway or completed on drawings or attach project specifications and give completion date(s) (M/D/Y)  FORMTEXT      / FORMTEXT      / FORMTEXT       Were the regulated activities conducted under a MDEQ permit?  FORMCHECKBOX  No  FORMCHECKBOX  Yes If Yes, list the MDEQ permit number  FORMTEXT      Are you aware of any unresolved violations of environmental law or litigation involving the property?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, explain)  FORMTEXT       8 ADJACENT/RIPARIAN AND IMPACTED OWNERS (Attach additional sheets if necessary) Complete information for all adjacent and impacted property owners and the lake association or established lake board, including the contact person's name. If you own the adjacent lot, provide the requested information for the first adjacent parcel that is not owned by you.Property Owners NameMailing AddressCityStateZip Code FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT      Name of  FORMCHECKBOX  Established Lake Board  FORMCHECKBOX  or Lake Association and the Contact Person's name, phone number, and mailing address  FORMTEXT       9 APPLICANT'S CERTIFICATION READ CAREFULLY BEFORE SIGNING I am applying for a permit(s) to authorize the activities described herein. I certify that I am familiar with the information contained in this application; that it is true and accurate; and, to the best of my knowledge, that it is in compliance with the State Coastal Zone Management Program. I understand that there are penalties for submitting false information and that any permit issued pursuant to this application may be revoked if information on this application is untrue. I certify that I have the authority to undertake the activities proposed in this application. By signing this application, I agree to allow representatives of the MDEQ, USACE, and/or their agents or contractors to enter upon said property in order to inspect the proposed activity site and the completed project. I understand that I must obtain all other necessary local, county, state, or federal permits and that the granting of other permits by local, county, state, or federal agencies does not release me from the requirements of obtaining the permit requested herein before commencing the activity. I understand that the payment of the application fee does not guarantee the issuance of a permit.  FORMCHECKBOX  Property Owner  FORMCHECKBOX  Agent/Contractor  FORMCHECKBOX  Corporation/Public Agency  Title  FORMTEXT       Printed Name  FORMTEXT       Signature Date (M/D/Y)  FORMTEXT      / FORMTEXT      / FORMTEXT        10 PROJECTS IMPACTING WETLANDS OR FLOODPLAINS OR LOCATED ON AN INLAND LAKE OR STREAM OR A GREAT LAKE Check boxes A through M that may be applicable to your project and provide all the requested information. If your project may affect wetlands, also complete Section 12. If your project may impact regulated floodplains, also complete Section 13. To calculate volume in cubic yards (cu yd), multiply the average length in feet (ft) times the average width (ft) times the average depth (ft) and divide by 27. Some projects on the Great Lakes require an application for conveyance prior to Joint Permit Application completeness. (Provide a cross-section and overall site plan showing existing lakes, streams, wetlands, and other water features; existing structures; and the location of all proposed structures, land change activities and soil erosion and sedimentation control measures. Review Appendix B and EZ Guides for completing site-specific drawings. (Provide tables for multiple impact areas or multiple activities and provide fill and excavation/dredge calculations. Water Level Elevation On a Great Lake use IGLD 85  FORMCHECKBOX  surveyed  FORMCHECKBOX  converted from observed still water elevation. On inland waters,  FORMCHECKBOX  NGVD 29  FORMCHECKBOX  NAVD 88  FORMCHECKBOX  other  FORMTEXT       Observed water elevation (ft)  FORMTEXT       date of observation (M/D/Y)  FORMTEXT        FORMCHECKBOX  A. PROJECTS REQUIRING FILL (See All Sample Drawings) Attach both overall site plan and cross-section views to scale showing maximum and average fill dimensions.(Check all that apply)  FORMCHECKBOX  floodplain fill  FORMCHECKBOX  wetland fill  FORMCHECKBOX  riprap  FORMCHECKBOX  seawall, bulkhead, or revetment  FORMCHECKBOX  bridge or culvert  FORMCHECKBOX  boat launch  FORMCHECKBOX  off-shore swim area  FORMCHECKBOX  beach sanding  FORMCHECKBOX  boatwell  FORMCHECKBOX  crib dock  FORMCHECKBOX  other  FORMTEXT       Fill dimensions (ft) length  FORMTEXT       width  FORMTEXT       maximum depth  FORMTEXT       Total fill volume (cu yd)  FORMTEXT      Maximum water depth in fill area (ft)  FORMTEXT      Type of clean fill  FORMCHECKBOX  pea stone  FORMCHECKBOX  sand  FORMCHECKBOX  gravel  FORMCHECKBOX  wood chips  FORMCHECKBOX  other  FORMTEXT      Will filter fabric be used under proposed fill?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, type)  FORMTEXT      Source of clean fill  FORMCHECKBOX  on-site, (If on-site, show location on site plan.  FORMCHECKBOX  commercial  FORMCHECKBOX  other, (If other, attach description of location.Fill will extend  FORMTEXT       feet into the water from the shoreline and upland  FORMTEXT       feet out of the water. Fill volume below OHWM (cu yd)  FORMTEXT       FORMCHECKBOX  B. PROJECTS REQUIRING DREDGING OR EXCAVATION (For dredging projects see Sample Drawing 7, for excavation see other applicable Sample Drawings) Attach both overall site plan and cross-section views to scale showing maximum and average dredge or excavation dimensions and dredge disposal location. Refer to  HYPERLINK "http://www.michigan.gov/jointpermit" www.michigan.gov/jointpermit for disposal requirements and authorization.(Check all that apply)  FORMCHECKBOX  floodplain excavation  FORMCHECKBOX  wetland dredge or draining  FORMCHECKBOX  seawall, bulkhead, or revetment  FORMCHECKBOX  navigation  FORMCHECKBOX  boat well  FORMCHECKBOX  boat launch  FORMCHECKBOX  other  FORMTEXT      Total dredge/excavation volume (cu yd)  FORMTEXT      Dimensions length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Dredge/excavation volume below OHWM (cu yd)  FORMTEXT      Method and equipment for dredging  FORMTEXT      Has proposed dredge material been tested for contaminants?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, provide test results with a map of sampling locations.Dredged or excavated spoils will be placed  FORMCHECKBOX  on-site FORMCHECKBOX  off-site. (Provide detailed disposal area site plan and location map. (Provide letter of authorization from owner, if disposing of spoils off site.Has this same area been previously dredged?  FORMCHECKBOX  No  FORMCHECKBOX  Yes If Yes, date and permit number:  FORMTEXT      /  FORMTEXT      /  FORMTEXT      /  FORMTEXT       If Yes, are you proposing to enlarge the previously dredged area?  FORMCHECKBOX  No  FORMCHECKBOX  Yes Is long-term maintenance dredging planned?  FORMCHECKBOX  No  FORMCHECKBOX  Yes If Yes, when and how much?  FORMTEXT       FORMCHECKBOX  C. PROJECTS REQUIRING RIPRAP (See Sample Drawings 2, 3, 8, 12, 14, 17, 22, and 23. Others may apply)Riprap waterward of the FORMCHECKBOX  shoreline OR  FORMCHECKBOX  ordinary high water markDimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Volume(cu yd)  FORMTEXT      Riprap landward of the  FORMCHECKBOX  shoreline OR  FORMCHECKBOX  ordinary high water mark Dimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Volume(cu yd)  FORMTEXT      Type of riprap  FORMCHECKBOX  field stone  FORMCHECKBOX  angular rock  FORMCHECKBOX  other  FORMTEXT      Will filter fabric be used under proposed riprap?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, type)  FORMTEXT       FORMCHECKBOX  D. SHORE PROTECTION PROJECTS (See Sample Drawings 2, 3, and 17) Complete Sections 10A, B, and/or C above, as applicable. (check all that apply)  FORMCHECKBOX  riprap  length (ft)  FORMTEXT        FORMCHECKBOX  seawall/bulkhead  length (ft)  FORMTEXT        FORMCHECKBOX  revetment  length (ft)  FORMTEXT      Distances of project from both property lines (ft)  FORMTEXT       FORMCHECKBOX  E. DOCK - PIER  MOORING PILINGS  ROOFS (See Sample Drawing 10)Dock Type  FORMCHECKBOX  open pile  FORMCHECKBOX  filled  FORMCHECKBOX  crib Seasonal support structure?  FORMCHECKBOX  No  FORMCHECKBOX  YesPermanent Roof?  FORMCHECKBOX  No  FORMCHECKBOX  Yes Mounted on  FORMTEXT       Maximum Dimensions: length  FORMTEXT       width  FORMTEXT       height  FORMTEXT      Proposed structure dimensions (ft) length  FORMTEXT       width  FORMTEXT      Dimensions of nearest adjacent structures (ft) length  FORMTEXT       width  FORMTEXT       FORMCHECKBOX  F. BOAT WELL (See EZ Guides)Type of sidewall stabilization  FORMCHECKBOX  wood  FORMCHECKBOX  steel  FORMCHECKBOX  concrete  FORMCHECKBOX  vinyl  FORMCHECKBOX  riprap  FORMCHECKBOX  other  FORMTEXT      Boat well dimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT       Number of boats  FORMTEXT      Volume of backfill behind sidewall stabilization (cu yd)  FORMTEXT      Distances of boat well from adjacent property lines (ft)  FORMTEXT       FORMCHECKBOX  G. BOAT LAUNCH (See EZ Guide) (check all that apply)  FORMCHECKBOX  new FORMCHECKBOX  existing  FORMCHECKBOX  public  FORMCHECKBOX  private  FORMCHECKBOX  commercial  FORMCHECKBOX  replacementProposed overall boat launch dimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Type of material  FORMCHECKBOX  concrete  FORMCHECKBOX  wood  FORMCHECKBOX  stone  FORMCHECKBOX  other  FORMTEXT      Existing overall boat launch dimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT       Boat launch dimensions (ft) below ordinary high water mark length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT       Distances of launch from both property lines (ft)  FORMTEXT      Number of adjacent Skid piers  FORMTEXT      Skid pier dimensions (ft) length  FORMTEXT       width  FORMTEXT       FORMCHECKBOX  H. BOAT HOIST (See EZ Guide)(Check all that apply)  FORMCHECKBOX  seasonal  FORMCHECKBOX  permanent  FORMCHECKBOX  cradle  FORMCHECKBOX  side lifter  FORMCHECKBOX  other  FORMTEXT       located on  FORMCHECKBOX  seawall  FORMCHECKBOX  dock  FORMCHECKBOX  bottomlands 10 Continued - PROJECTS IMPACTING WETLANDS OR FLOODPLAINS OR LOCATED ON AN INLAND LAKE OR STREAM OR A GREAT LAKE FORMCHECKBOX  I. BOARDWALKS AND DECKS IN  FORMCHECKBOX  WETLANDS - OR -  FORMCHECKBOX  FLOODPLAINS (See Sample Drawings 5 and 6. Provide table if necessary)Boardwalk  FORMCHECKBOX  on pilings  FORMCHECKBOX  on fill Dimensions (ft) length  FORMTEXT       width  FORMTEXT      Deck  FORMCHECKBOX  on pilings  FORMCHECKBOX  on fillDimensions (ft) length  FORMTEXT       width  FORMTEXT       FORMCHECKBOX  J. INTAKE PIPES (See Sample Drawing 16)  FORMCHECKBOX  OUTLET PIPES (See Sample Drawing 22)Type  FORMCHECKBOX  headwall  FORMCHECKBOX  end section  FORMCHECKBOX  pipe  FORMCHECKBOX  other  FORMTEXT      If outlet pipe, discharge is to  FORMCHECKBOX  wetland  FORMCHECKBOX  inland lake  FORMCHECKBOX  stream, drain, or river  FORMCHECKBOX  Great Lake  FORMCHECKBOX  other  FORMTEXT      Dimensions of headwall OR end section (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Number of pipes  FORMTEXT       Pipe diameters and invert elevations  FORMTEXT       FORMCHECKBOX  K. MOORING AND NAVIGATION BUOYS (See EZ Guide for Sample Drawing) (Provide an overall site plan showing the distances between each buoy, distances from the shore to each buoy, and depth of water at each buoy in feet. (Provide cross-section drawing(s) showing anchoring system(s) and dimensions.Number of buoys  FORMTEXT      Boat Lengths  FORMTEXT       Type of anchor system  FORMTEXT       Purpose of buoy  FORMCHECKBOX  mooring  FORMCHECKBOX  navigation  FORMCHECKBOX  swimmingDimensions of buoys (ft) width  FORMTEXT       height  FORMTEXT       swing radius  FORMTEXT       chain length  FORMTEXT       Do you own the property along the shoreline?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (Attach Authorization Letter from the property owner(s), if No above. FORMCHECKBOX  L. FENCES IN WETLANDS, STREAMS, OR FLOODPLAINS (No Sample Drawing available) Provide an overall site plan showing the proposed fencing through wetlands, streams, or floodplains. Provide drawing of fence profile showing the design, dimension, post spacing, board spacing, and distance from ground to bottom of fence.(check all that apply)  FORMCHECKBOX  wetlands  FORMCHECKBOX  streams  FORMCHECKBOX  floodplainsTotal length (ft) of fence through wetlands  FORMTEXT       streams  FORMTEXT       floodplains  FORMTEXT      Fence height (ft)  FORMTEXT      Fence type and material  FORMTEXT       FORMCHECKBOX  M. OTHER - e.g., structure removal or construction, breakwater, aerator, fish shelter, and structural foundations in wetlands or floodplains  FORMTEXT        11 EXPANSION OF AN EXISTING OR CONSTRUCTION OF A NEW LAKE OR POND (See Sample Drawings 4 and 15)Which best describes your proposed waterbody use (check all that apply)  FORMCHECKBOX  wildlife  FORMCHECKBOX  stormwater retention basin  FORMCHECKBOX  recreation  FORMCHECKBOX  wastewater basin  FORMCHECKBOX  other  FORMTEXT       Water source for lake/pond  FORMCHECKBOX  groundwater  FORMCHECKBOX  natural springs  FORMCHECKBOX  Inland Lake or Stream  FORMCHECKBOX  stormwater runoff  FORMCHECKBOX  pump  FORMCHECKBOX  sewage  FORMCHECKBOX  other  FORMTEXT      Location of the lake/basin/pond  FORMCHECKBOX  floodplain  FORMCHECKBOX  wetland  FORMCHECKBOX  uplandMaximum dimensions (ft) length  FORMTEXT       width  FORMTEXT       depth  FORMTEXT      Spoils will be placed  FORMCHECKBOX  onsite  FORMCHECKBOX  offsite outside of wetland and floodplain  FORMCHECKBOX  other  FORMTEXT       ( Provide a Detailed Disposal Area Site Plan with location map, address and disposal dimensions ( Provide a Letter of Authorization from off site disposal site owner ( Provide elevations and cross sections for outlets and/or emergency. Complete Section 10J,Maximum Area:  FORMCHECKBOX  acres  FORMCHECKBOX  sq ft  FORMTEXT      Will project involve construction of a dam, dike, outlet control structure, or spillway?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (If Yes, complete Section 17)12 ACTIVITIES THAT MAY IMPACT WETLANDS (See Sample Drawings 8 & 9, and complete sections 10 A and 10 B for dredge or excavation as applicable) For information on the MDEQ's Wetland Identification Program (WIP) visit  HYPERLINK "http://www.michigan.gov/deqwetlands" www.michigan.gov/deqwetlands or call 517-373-1170. Complete the wetland dredge and wetland fill dimension information below for each impacted wetland area. (Attach tables for multiple impact areas or activities Label the impacted wetland areas on a site plan, drawn to scale or with dimensions. ( Attach at least one cross-section for each wetland dredge and/or fill area. If dredge/excavation material will be disposed of on site, show the location on site plan and include soil erosion and sedimentation control measures.(check all that apply)  FORMCHECKBOX  fill (Section 10A)  FORMCHECKBOX  dredge or excavation (Section 10B)  FORMCHECKBOX  boardwalk or deck (Section 10I)  FORMCHECKBOX  dewatering  FORMCHECKBOX  fences (Section 10L)  FORMCHECKBOX  bridges and culverts (Section 14)  FORMCHECKBOX  draining surface water  FORMCHECKBOX  stormwater discharge  FORMCHECKBOX  restoration  FORMCHECKBOX  other  FORMTEXT      wetland dredge/excavation dimensions  FORMTEXT      maximum length (ft)  FORMTEXT      maximum width (ft)  FORMTEXT      dredge/excavation area  FORMCHECKBOX  acres  FORMCHECKBOX  sq ft  FORMTEXT      average depth (ft)  FORMTEXT       dredge volume (cu yd) FORMTEXT      wetland fill dimensions  FORMTEXT       maximum length (ft)  FORMTEXT      maximum width (ft)  FORMTEXT      fill area  FORMCHECKBOX  acres  FORMCHECKBOX  sq ft  FORMTEXT      average depth (ft)  FORMTEXT      fill volume (cu yd)  FORMTEXT      Total wetland dredge/excavation area  FORMCHECKBOX  acres  FORMCHECKBOX  sq ft  FORMTEXT       Total wetland dredge/excavation volume (cu yd)  FORMTEXT      Total wetland fill area  FORMCHECKBOX  acres  FORMCHECKBOX  sq ft  FORMTEXT      Total wetland fill volume (cu yd)  FORMTEXT       The proposed project will be serviced by:  FORMCHECKBOX  public sewer  FORMCHECKBOX  private septic system ( Show system on plansIf septic system, has an application for a permit been made to the County Health Department?  FORMCHECKBOX  No  FORMCHECKBOX YesIf Yes, has a permit been issued?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( Provide a copy.Has a professional wetland delineation been conducted for this parcel?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( Provide a copy of the delineation. (Supply data sheets.Applicant purchased property  FORMCHECKBOX  before OR  FORMCHECKBOX  after October 1, 1980.Is there a recorded MDEQ easement on the property?  FORMCHECKBOX  No  FORMCHECKBOX  Yes If Yes, provide the easement number)  FORMTEXT       Has the MDEQ conducted a wetland assessment for this parcel?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( If Yes, provide a copy of assessment or WIP number:  FORMTEXT      Describe the wetland impacts, the proposed use or development, and any alternatives considered:  FORMTEXT      Does the project impact more than 1/3 acre of wetland?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( If Yes, submit a Mitigation Plan that includes the type and amount of mitigation proposed. For more information go to  HYPERLINK "http://www.michigan.gov/deqwetlands" www.michigan.gov/deqwetlands Describe how impacts to waters of the United States will be avoided and minimized:  FORMTEXT      Describe how impact to waters of the United States will be compensated. OR Explain why compensatory mitigation should not be required for the proposed impacts.  FORMTEXT      Is any grading or mechanized land clearing proposed?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( Show locations on submitted site plan.Has any of the proposed grading or mechanized land clearing been completed?  FORMCHECKBOX  No  FORMCHECKBOX  Yes ( Show labeled locations on site plan. 13 FLOODPLAIN ACTIVITIES (See Sample Drawing 5. Others may apply.) For more information go to  HYPERLINK "http://www.michigan.gov/deqfloodplainmanagement" www.michigan.gov/deqfloodplainmanagement Complete Sections 10 A and 10 B and other Sections, as applicable. 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