1215 80TH ST SW 2016-01-01 MF Import

Cy t" HN K TO !E COMPLETED NY APPLICANT EVALUATION FOR 135:0 AGESICY LSE ONLY ' ). Water to I t a. Surface: Z 1) Is there any surface water body on or in tee immediate vicinity of the site (including Hp Hd sear-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes. ducribe type 0 ~ g tnd provide names. If appropriate. state what stream or river it flows into. U 0. 0 H Y H None tg" En H '_) Will the project require any work over, in, or adjacent to (within 200 feet) the described n R 1 I4 .aters? If yes, please describe and atuch available plans. H to NO H O tri )) Estimate the amount of fill and dredge material that would be placed in or removed irem surface water or wetlands and indicate the area of the site that would be affected. In- Ilcate the Source of .111 material. None a) Will the proposal require surface water withdrawals or diversions? Give general de. 1 script on, purpose, and approximate quantities if known. Diverson of street drainage to proposed retention pond C3 5) Does the proposal lie within a 100-year floodplain? If so, note location an the site C_• .o I 6) Does the proposal involve any discharges of waste materials to surface waters? If so, I descnbe the type of waste and anticipated volume of discharge. No b. Ground: 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. No �l \ l 2) Oexribe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage. industrial, containing the following chemicals . . .: agricultural: etc.). Describe the general site of the system, the number of such systems, the number of houses to be served (if applicable), or the number or animals or - humans the system(s) are expected to serve. Not during development