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<br /> ' �.' Agency Requfring Checkll�t ��v:�tG �� �'�n�e��4�0• �'p�', Yee Mey�e No
<br /> ' 6. Nnmc of Proposnl, ir o��,no,�n�«
<br /> !A W 4cF�� J�p� F�R AVC_RSav,HvvrFp ����<� �o��Ns �r (9) Wntr.r. Will the proposN rest It 1n: ; .
<br /> 6. Nnluir. nnd IlriaC Ur.scriptiou nf the Propus� (incluJing Uut not ' •
<br /> limiled lo its eizc, generul desl�n clemr.nts, mid other fnetara (e) Chnnges in currents, or the wuree �
<br /> thet will give an accurete understnnding of its scope ond or dlreclion oi wnler movementa, in �
<br /> nature): CLVS L�Y��i:�Ni �hSEM,ENT � etlhcr mnrine or fresh wetera? � ✓ ��
<br /> �iy0 S7•�� c,l:-�'fE Otfl�;r •L � � 9/to , •.rA�N�p woaD � .
<br /> �Dr+!� r<.?i�,�,� ���inmqa p nct ,-„�q a:e•�� D�?/hL (b) Chenges in nbeorption retea, �
<br /> 7. Localion of Proposnl (describe 1he physimi sr.tting o!ihe � C p�ti}G7ER , ' drnlnnge palierne, or lhe rete nnd � L
<br /> propoanl, an well cs (he extent of lhe lnud nren atfecled by n�y�E� �'r7���� emounl of sur[aco weler runo[[? f
<br /> envh�anmcnml tmpucto, includiu�nny other Iuformntiou needed`��'"�F��nO'�IS. - -
<br /> 10 Blve nn accurnle underatending ot the envlronmentN cetting (e) Alterntione to the course or dmv � ~ '�
<br /> of lhe proposnl): �U7T!;�i�.7 1dF,VEA .^Ak�t � 33EP ST. j(-�4 �GYR.�,S/d�GLE ot tlood watere4 i
<br /> C.4n,�tv RcSiJ�^.�rF� �' ArA�3rnrFurr � � dnr� f/���eKTy SGOPFS - -
<br /> Oc. �,r, ,r, n�.��A� ya kLL�Y. 7r,c't+rm2ihc ViE{y tp G,ur' (d) Change in lhe nmount ot sur[ett ✓ . '
<br /> walcr in uny watcr body? .
<br /> !. Cetlmnted Dnte[or Compfetion of thc I'roposed AcUon: � '
<br /> JUL / 79' (e) U[echerge into eurfnce welere, or !
<br /> 9. List ot nll Permils, Licmises or Covernment A.pprovnlo ReqWred !n uny alterntlon o[surface water � i
<br /> for the Proposal (federni, etatc and locol--includinQ rezones): qunlily, including but nol Iimlted to
<br /> E✓_o�T7' SI.DC- !'-�rqr�T Ev�/.tE7T UC�Vr�tiiN /N lem crature, diesolved o en or
<br /> „ G DEPT•UPA h'f n �n's y ,
<br /> p���rr Fv�;r��� y2QFF� .nF�_pv�ves�fh�X�¢ lur6idily? • '
<br /> — �--�� �v��'�!.u�_PE?MIT tVEQE7r PL/tNN�NG G��T' — — � .
<br /> 10. Do ou have on �(0 Nterotion o[the dlrecHon or � ,
<br /> . Y y plans for future edditlons, expnnston, or ret�e of[low o(ground vatere7 -
<br /> turlher nctivlty rclnted to or rnnnecled svith lhie proposnl? I( .
<br /> yea, ezplain: �
<br /> NO. , (g) ChanQe In O�e quentlty ot
<br /> . ground watcrs, eithar lhrough
<br /> _ dircet eddiliane or wlth.drewals, cr ;
<br /> � lhrough intcrcepUon ot nn nquffer by �
<br /> 11 Do you kno�v oC any plans by oWere whlch mny nffeM lhe cute or excncations? ' .
<br /> property covnred by your proposnl? If yes, expinin:
<br /> _ Nn. ' (h) Deteriornqon in ground water
<br /> qunllry, elthcr lhr.mgh d�rccl ln-
<br /> }�. Attach any other applicnlion form that hnx been mmpleted jection, or through the acepnge o[
<br /> tegarding thu prnposol; it none hns been comp]eted, but le lrnchale, pl�o�phnlea, datergente, � �
<br /> expceted to be filud nt eome fuluro dele, doecttba ihu ne�ure wal��rborne vlrus or bnetcrin, or � }
<br /> o(ruch applfcation form: othcr subetancee Into the ground � ?
<br /> ---NS'NE Matern? — _,_ • . G
<br /> (U Iteducllon 1n ihc amount o[ ,
<br /> wulcr othcrwiso nvnilubla for pabllc
<br /> - welcr supplles? _ _ � �
<br /> Bxpinnntion: d �VE7, �RC/Ah'r /1QE � ,�kt/NS. �.
<br /> i�) ��/TRD �sn r7y �cu�NA6L MTE�Y� �� f�'JR`.II .A4M/ai{�E �
<br /> co,vc�.v��� �i gtvsM.e,K r, �bwEva�c s7Ran, w�-tt,e ;
<br /> � �JAl7,�011E9 8Y 4'ML'R ,¢t�lYN770N P/IC Wi/1`/i�RNvi. JIJPT
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