SECTION F.  APPLICATION COMPLETENESS CHECKLIST

(Applicant must place an entry - Y = Yes, N = No, N/A = Not Applicable ‑ in each left side column space.  See Section 105.13 for additional details.  If you are applying under the Small Projects Application format, place an entry in only those comments prefixed by an asterisk (*). (we may not have to do each of the items below, we would have to find out more)

REQUIREMENT

Applicant Entry

DEP Use Only

a.     GIF and permit application properly signed, sealed and witnessed

*     

b.     Application Fee enclosed (see Section G.)

*     

c.     Copies and proof of receipt - Act 14 notification - Acts 67/68/127

*     

d.     Cultural Resource Notice - Copy and Proof of Receipt

*     

e.     Completed and approved Pennsylvania Natural Diversity Inventory Form (PNDI search)

*     

f.      Plans (site plan including cross sections and profiles for Subsections 151, 191, 231, 261)

*     

g.     Location map

h.     Project description narrative

*     

i.      Color photographs with map showing location taken

*     

j.      Environmental Assessment form

*     

k.     Erosion and Sediment Control Plan and approval letter

l.      Hydrologic and hydraulic analysis

m.   Stormwater Management Analysis w/consistency letter

n.     Floodplain Management Analysis w/consistency letter

o.     Risk Assessment

p.     Professional engineer’s seal and certification

q.     Alternative analysis

r.      Mitigation plan

SECTION G.  DETERMINATION OF APPLICATION FEES (DEP FEES ONLY)

Types of Water Obstructions and Encroachments

Number of Units

Fee Per Unit

Subtotal Amount

Stream enclosures

$ 350.00

$      

Channel changes

$ 300.00

$      

Commercial dredging
(Should we be doing this one? Even though we are doing recreational, also this means that every dredge we list would cost 300$ to process)

$ 300.00

$      

Peat extraction

$ 750.00

$      

Fills, levees, floodwalls

$ 350.00

$      

Bridges and other water obstructions and encroachments

$ 200.00

$      

Small projects ($100 fee regardless of number of units)
(I'm not doing commercial dredging it's recreational do I do this one?)

(Unlimited and it's still only $100)

$ 100.00

$      

Qualifies for General Permit (fee waived)
(Do we qualify? Do we have to pay a fee to apply before I can find out? )

$0.00

N/A

Make Check Payable to:
Commonwealth of Pennsylvania                                                                TOTAL FEE

$      

List each type and number of water obstructions and encroachments that are included in this application and indicate subtotal and total fee amounts. (This means, I guess, each dredge's "type" meaning power and size and how much material it moves, as in what the Recreational Prospecting in the Commonwealth's Waterways" Fact sheet said)

FAILURE TO PROVIDE ALL OF THE REQUESTED INFORMATION WILL DELAY THE PROCESSING OF THE APPLICATION AND MAY RESULT IN THE APPLICATION BEING PLACED ON HOLD WITH NO ACTION, OR IT MAY BE CONSIDERED WITHDRAWN AND THE FILE CLOSED.

SECTION H.     ADJOINING PROPERTY OWNERS

Please list the name and address of all property owners whose land adjoins the project property.

NAME

ADDRESS

SECTION I.       CERTIFICATION AND SIGNATURE

 (This section seems to be who will be responsible for this permit if some one is caught doing something wrong,)

If Privately Owned, all owners (such as husband and wife) must sign.  One or more members authorized to sign on behalf of an entire partnership must sign.  For a Corporation, the president, vice president or other responsible official is required to sign.  For Political Subdivision, signatures of the chief officer or other responsible official empowered to sign is required with the seal affixed and attested by the clerk.  For Commonwealth departments, boards, commissions, receivers, trustees and authorities, a department head, bureau director, executive director, chairman, commissioner or other responsible official is required to sign.  Signatures other than above must be accompanied by a power of attorney or other notarized legal documentation indicating authorization to sign on behalf of the applicant.

 Application is hereby made for a permit to authorize the activities described herein.  I certify I am familiar with the information contained in this application, and to the best of my knowledge and belief, such information is true, complete and accurate.  I further certify I possess the authority to undertake the proposed activities.

 I certify that the project proposed in this application complies with and will be conducted in a manner that is consistent with the approved Coastal Zone Management program of the Commonwealth of Pennsylvania.  (Only portions of Erie, Bucks, Philadelphia and Delaware Counties are in the Coastal Zone).

 I grant permission to the agencies responsible for authorization of this work, or their duly authorized representative, to enter the project site for inspection purposes during working hours.  I will abide by the conditions of the permit or license if issued and will not begin work without the appropriate authorization.

                By:                                                                                                                                       

                            (PRINT NAME)

                            (SIGNATURE)                                                                                              (DATE)                                              SEAL

                            (TITLE)

WITNESS: