10915 16TH AVE SE 2016-01-01 MF Import

, � � ' TO BE COh1PLETED BY APPLICANT EVALU�TION FOR J. W3[Cf � �GENCY USE ONLY ' 8. �IIff3CC: I) Is there any surface watcr body on or in the immediate vicinity of the site (including year—round and scasonal streams, saltwater, lakes, ponds, weclands)? If yes, describe typc and provide names. If appropriate, sta[e what scream or river it flows into. Yes, Silver Lake approximately � mile south of property. 2) Will che project require any work over, in, ar adjacem to (within ?00 feet) the described wa[ers° If yes, please describe and attach available plans. No. 3) Estimate the amount oi fill and dredge matcrial that would be placed in or removed (rom surFace water or wetlands and indicate the area of the site that would be aFfec[ed. In- dicate thc source of fill material. None. 4) Will the proposal require surfacc water withdrawals or diversions? Give general de- scription, purpose, and approximate quantities if known. r�. 5) Does the proposal lie within a 100—year Iloodplain? I( so, note location on the site plan. No. 6) Does the proposal involve any discharges of waste materials to surface wa[ers? I( so, describe the type oC waste and anticipaced volume of discharge. Na. , b. Ground: I) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. No. ?) Describe wasce material that will be dischareed inta the ground from scptic tanks ar other sources, iF any (for exampic: Damestic sewage; industrial, containing thc tollawing chemicals . . .; agricultural; e[c.). Describe the gcneral size of the system, the number of such systems, the num6er of houses to be served (iC applicable), or the number of animals or humans [he system(s) are expected to serve. None. , I 4 . I