HomeMy WebLinkAboutTR-5465
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TERMS and CONDmONS
The Pennittee
William Lehmann
residing at 730 Rabbit Lane. East Marion N. Y., as
part of the coosideratioo foe the ¡,;..··nœ of the Pamit does I1Ødeøtaod and prescribe to the fol-
lowiøg:
1. That the said Board of Trustees and the T...... of Soucbo1d ate released &am aøy and
aU damages, or cWms foe damages, of suiø arisiøg ditecdy or iødirecdy as a ftIUk of aøy oper-
atioa performed pinuabt to dùs permit, and the said 1'>-. ...I.."", will, lit his or her OWD u¡-.
defend aøy and aU such adts·/"¡"¡""'¡ by third parda, ..... the said 1'>. 1,,- as-- fall 1iIbIIicy
wùb respect thereto, to the ~ _...w. of the Boød of T~ of the TOWD of ~
2. That dùs Permit is nlid for . period of 24 mos. which is ~Ied to be the
esâmated time· requùed Iio complete the wod< iawl1'ed, but ihoa1d CÍláIIiI5WICCS WD'ftØt, ~
for on exœøsioo may be made to the Board at . later daœ.
3. That this Permit should be retaiaed iadefudtdy. or as loog as the said Permittee wishes
to m.i.....in the structure or project iawlved, to provide evidenœ to onyoae roaœmed that auth-
orizatioo was origiaa11y obtaiaed.
4. That the wodc iawlved will be IUbject to the iaspectioo ..... approval of the Board or
Its agents, and noø-œmp1iaøce wùb. the provisions of the otig/no'"'g appliatioa, may be cause for
revocatioo of this Pamlt by resolutioo of the said Board.
5. That there will be no untf'OSOI"Ible iaterference wùb navigatioa as a result of the WIlde
baeia authorized.
6. That there maU be no iatetference wùb the right of the public to pass and repass a100g
the bead>. between high and low water marks.
7. That if future operations of the Town of Soucbo1d reqa1re the I'eII1Oft1 and/or allltudoas
ia the location of the 1VOdt bereia ..1J>o.o¡'r~. or if, ia the opinion of the Board of T.-, the.
wodc shall cause unreasonah1e obstractlO<1 to free navigatloa, the said Pamittee will be rec¡u1œd,
apoa due notiœ, to remove or dter dùs wodt or project bereia stated without eoren"'" to the TOWD
of Soulbold.
8. That the said Board will be notified by the Petmiuee Ot the ..-pIccb. of the work auth-
orized.
9. That the Permittee wiU obtain .U other permits and .......-.. that -.y be required sup-
plemental to Ibis permit which _y be subject to revoke upoa fdlute to obtain same.
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
.
.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 21,2001
Mr. John Costello
Costello Marine Contracting Corp.
P.O. Box 2124
Greenport, NY 11944
RE: WILLIAM LEHMANN
730 Rabbit Lane, East Marion
SCTM#3l-l7-l7&31-18-16
Dear Mr. Costello:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, December 19, 2001 regarding the above matter:
WHEREAS, Costello Marine Contracting Corp. on behalf of WILLIAM LEHMANN applied
to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance ofthe
Town of Southold, application dated November 29,2001, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory Council
for their findings and recommendations, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on
December 19, 2001, at which time all interested persons were given an opportunity to be heard,
and,
WHEREAS, the Board members have personally viewed and are familiar with the premises in
question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and docwnentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 97 of the Southold
Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect the health,
safety and general welfare of the people of the town,
2
.
.
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of WILLIAM LEHMANN to
remove and dispose of a 44' portion of an existing jetty. Install a new 44' jetty in-kind, in-place,
using CCA treated materials, with the condition that the new jetty starts 22"-24" from the top of
the deck.
BE IT FURTHER RESOLVED that this determination should not be considered a determination
made for any other Department or Agency, which may also have an application pending for the
same or similar project.
Permit to construct and complete project will expire two years from the date it is signed. Fees
must be paid, if applicable, and permit issued within six months of the date of this notification.
Two inspections are required and the Trustees are to be notified upon completion of said project.
Fees: None
Very truly yours,
~~ /~-~~'ç.
Albert J. Krupski, Jr.
President, Board of Trustees
AJKilms
DEC
ACE
Dept. of State
.
.
Telephone
(631) 765-1892
Town Hall. 53095 Main Road
P.O. Box 1179
Sou/hold. New Yark 11971
SOUTHOLD TOWN
CONSERVATION ADVISORY COUNCIL
At the meeting of the Southold Town Conservation Advisory Council held Thursday,
December 13, 2001, the following recommendation was made:
Moved by Drew Dillingham, seconded by Scott Hilary, to
TABLE the Wetland Permit Application of WILLIAM LEHMANN to remove and dispose
of a 44' portion of an existing jetty. Install a new 44' jetty in-kind, in-place using CCA
treated materials.
Located: 730 Rabbit Lane, East Marion. SCTM#31-17-17&31-18-16
The CAC questions the need for replacement and has a concern with the amount of
material that's being excavated.
Vote of Council: Ayes: All
Motion Carried
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PRoP05ED: ReMOVIN(3 AND OISP061i'JG OF A <4-+ PORTION OF AN EXlfoTI....<!'I
JETTY. IN5TAL.Lii'JG A ....EW 4-+' ..JETTY IN-KINO, I....-PL.AC~
U51NG CCA TREAT£D MA"ERIAL~.
ACCE5S: .ð,( WATER, 1.,J51 .JG CRA....e/bARGE.
PREPARED e,y,
COSTELLO MARINE CONT~CTING COR...
P.o. ðOX 2124 GRe.ENPORT, N"'C' ""'4"-
c:¡,~1-4'17- lIee>
Nf1V 2 9 L
WILLIAM LEHMANN
2(ó WHITE eolRCH CIRCL.E
M I L.L.ER PLACE, N,( 117cÞ+
(7$0 RAeoeolT LA., eA6T MARIO....)
&.C.T.M. 1000-31-17-17 e.
1000-31-lð-lc:¡,
OCT. 20,2001
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Albert J. Krupski, President
James King, Vice·President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
.....f?astaI Erosion Permit Application
_Wetland Permit Application /Major Minor
_ Waiver/Amendment/Changes .
_-1(eceived Application:~
~eceived Fee:$ ~-
~mpleted Application~
_Incomplete
SEQRA Classification:
Type I_Type II_Unlisted_
_coordination:(date9lŒent
",cAC Referral Sent: I
~e ofInspection: I '"
_Receipt ofCAC Report:
_Lead Agency Determination:
Technical Review:
A'Ublic Hearing He~
Resolution:
Name of APplicant~ lfV\VWlX\Vì
~--p,\~(11 C\vr Ie M1l\¿\('.tlQrt' I ~
PhoneNumber:( ) ~?,\) i3lD -I:nlnq~
,
Suffolk County Tax Map Number: 1000 - ...3L:..D - \1 ": \000 - 3\ - \ CO - \ l.o
Address Jlo
Lt1l04
Property Location: 730 ~bl t Lo...w:.
..
--,-,----
!' f' ¡
Ö)st IV\twÝ\ t\\ '{ U q 3q
(provide LILCO Pole #, distance to cross slreets, and location)
. .
AGENT: tosk\1D Max-IVY.J
(If applicable)
NOV 2 9 2110l
.
~OOtr-OChnq ODVþ.
.r!
ø~~i
Address:
Yi Y
Phone: 00~\) 411- œq
.
.
Board of Trustees Application
GENERAL DATA
Land Area (in square feet):
Area Zoning:_~<:.,(\P\'\ti.aJ WlITtvoV\+
,
Previous use ofproperty:--þ~\\il1 ~ re'S~ \A.k) ffWOfI+
Intended use of property:
Sa.vve...
Prior permits/approvals for site improvements:
Agency
Date
LlV\ trow V\
_ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
1-No_Yes
If yes; provide explanation:
Project Description (use attachments if necessary):
_~YW)\ff'_. t1\}rL.chs~. of (l ~+LOVl n.f an
exts+\~ iHy. lt15:Ia11 0 v1PW 44 Ijf>tty \V\~GVld,
'y\:"þ~cf, IlSlŸlq CÎ'A +rPlJted VVla~t'\ã(s.
· .
Board of Trustees Application
WETLANDffRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
_-h.. Vld1û'VÍ iHy
<
v\l.ïlJd:L_ddr P !()'VQ i1 ~
Area of wetlands on lot:
o
o
square feet
Percent coverage oflol:
%
Closest distance between nearest existing structure and upland
edge of wetlands: öì 1 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: FJ feet
Does the project involve excavation or filling?
No
'/..
Yes
¡fyes, how much material will be excavated?_IOO cubic yards
How much material will be filled?-.JÚO
cubic yards
Depth of which material will be removed or deposited:
feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
13aåVtD 100&_ \?
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such propos:d operations (use attachments ifapPTopriate):
,
eyní'YOY\l'1"'e.v\t dIe. ill (")(H" ~ (.
.
~
Board of Trustees Application
County of Suffolk
State of New York
JIlv\e CDS-\e~ BEING DUL Y SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF IDS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN TIDS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTH OLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARlSING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR
REPRESENT A TIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
d:t~dh
/' Signature
SWORN TO BEFORE ME THIS cY If DAY OF J¡¿;¿)~ ,200(
~~Ætd~~
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-::.~::: :; t~e'H York
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. - '~{JU::;:::;---
- .
.
.
Town Hall
. 53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Telephone (631) 765-1892
Fax (631) 765-1366
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
-----------------------------------
In the Matter of the Application
of
_ .u.1\\\tAro.. Jæ~~n.t)_ _ _ _ _ _ _ _ _ _ _ __
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
I, St1lMÀ~Q,ý 6vw/ ,residing at Æ(j Ma_it'l Sr, ApT- Z~
0n DA ~* ( NY \ \'94-L/
being d ly sworn, depose and say:
That on the 1\1b- daï. ofÞc~þ(r, 2001, I personally, posted the
property known as --=í 7;V 'fSaloh ~"í ~~ I f'o. -s+ ~'OY1, 1'" 'ý l \ '1 3'1
by placing the Board of Trustees official poster where it can
easily be seen, and that I have checked to be sure the poster
has remained in place for eight days prior to the date of the
~arca£)ôl!1nSJ~t~~ hearing noted thereon to be held~'~t~
Dated:'b~\I.\.d-oOI
Sworn to before me this
day of~c.~"'''''''' 200 \
~~
( . ature)
R:Jb':./: L. , -~ ,![It-I
Notary Pub¡;c, St."!., "1 New Yor'
No: n"" ,,·r~::,O:l91C·f
Qualif!c'0 .r' --:'II':f:~i!~ Gount}'
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.
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the matter of applicant:
SCTM#1000-
YOU ARE HEREBY GIVEN NOTICE:
~
\C~ - 31- 18-11P
1. That it is the intention of the undersigned to request a
Permit from the Board of Trustees to:
1«V\-\oý{" 0X1d. d~spo',>e of. q, 44' p>V'hcM of 0-.1'\ ~x~Sh~
J~tty. \V\s\<¡,ll It. Y\(w 44' jeth.¡ llÌI-t.ùv:l1 llÌl-plG\.C~ I.tS~Yl'1
CC,A ÌYtIL-tA' IVawals.
2. That the property which is the subject of Environmental
Review--.is located adjacent to your property and is described as
follows:
Î ~O 'K.a.bk>d LQ..V\e....
E..a.SI- MA.VïOVt l N '(
3. That the project which is subject to Environmental Review
under Chapters 32, 37, or 97 of the Town Code is open to public
comment on: You may contact the Trustees Office at
765-1892 or in writing.
The above referenced proposal is under review of the Board of
Trustees of the Town of Southold and does not reference any
other agency that might have to review same proposal.
OWNERS NAME:_bh\\;a.W\ lPIAMIl.V\Vî ( .
MAIL'ING ADDRESS: Ò)l. wki Ie ~I..,\í¡ Ôrde
tv'I.llrf ·PIa,,. . NY 11;1.4-
PHONE I: .
Ene.: Copy of sketch or plan showing proposal for your
convenience.
s
JOINT APPLlCA TI
FOR PERMIT
~pl>Caole 10 agenC>e5 end pemlll calegO( e5 1!lIed IfIllem 1
1. Check pennltl applied for:
NYS Dept. of Environmental Con..rYltlon
o Stream Disturbance (Bed and Banks)
o
o
o
o
o
o
o
o
o
o
o
o
o
NavlgaDle Waters (excavation and FlU)
Docx.s. Moonngs or Platforms
(Constl1Jct or Place)
Dams and Impoundment Structures
(ConsInJct. Reconstruct or Repair)
Freshwater Wetlands
Tidal Wetlands
Coastal Erosion Control
\^/ild. SceniC and Recreational Rivers
401 Water QualIty Certification
Potable Water Supply
long Island Wells
Aquatic Vegetation Control
Aquatic Insect Control
Flsn Control
NYS Office of General Servlc..
(State Owned Lands Under Water)
o lease, License. Easement or
other Real Property tnter,s!
D Utility Easement (pipelines. conduits,
cables. ate:)
o Dock.s, Moonngs or Platforms
(Construct or Place)
Adirondack Park Agency
o Freshwater Wetlands Permit
o 'Nila. Scenic and Recreational Rivers
Lake George Park Commission
o Docks (Construct or Place)
o Moonngs (Establish)
US Anny Corp. of Engln"",
o Section 404 (Waters of the United States)
o Section 10. {Rivers and Harbors Act)
o NationWIde Permit (S)
Identify Number(s)
For Agency UM Only
DEC APPLICATION NUMBER
us ARMY CORPS OF ENGINEERS
*
95·1')·3 ,8IWIç..T~
rf.iiif1iI
IY:IJ
a York State
United States Army Corps of Engineers
PI.... 11I8d .Um!Ncllonl on DecK Attach .dclitIon8 Inform.llon .1 needed. P..... pnntleglbly or type
(daytime)
4
3. Taxpayer 10 (If applicant Is not an individual)
4. AppllQnt I, alan: (check as many as apply)
Owner 0 Operator 0 lessee 0 Mumcipallty I Governmental Agency
¥'
6. Project I Facility Location (mark location on map,
Coun TownlCltyMllage:
,
-I/o
8. Name of USGS Quad Map:
Location Coordinates:
NYTM-E
NYTM-N 4
9. Project Description and Purpose: (Category of Activity e.g. new constructJoollnstallatiOn maintenance or
replacement; Type of Structure or ActiVity e.g. bulkhead, dredging, filhng, dam. dock. taking of water Type 01 Matenals
an~ntities; Structure a~d ~0rt¡ ArëfiimenSions; Need or Purpose Served)
. . . Ken10Ve. .. ana . . . i~~~..o... ~I . pcg.f¡O·\I\ of
..aY\. ~.I~W:\C1-. JefuJ.·..lo ~ H. 0.... n.e.U)44lj~tk¡
. .\ri.,:,~nd__\.IŸ:\ .-pþ.ÇR. __ .U.~Lv\q __.. .CtA... hm.0:f
.1'Y'4~t()j. .
_ _ _ _ _ _ _ _ _ , - .
.---------...------------.------ -------------------------------
----------------
.-11..--
------------
- - - . - - - - - -
. ropol II:
P~' !;lYe £;¡m_,
11. Will Project Occupy
S.... Land? ~ 0
:¡r.No
12. Propolld Start
Date:
13, Estimated Completion
Date
14. Has Work Begun on Project? (If yes, attach 0 g 15. Lilt Prevloul Permit I Application Numbers end Date.: (If Any)
explanation of wny work was started without permit.) V.I ¡;
16. Will this ProJeçt Require Additional
Federal, State, or Local Permlts1.
"£!
o
No
If Yes,
Please list.
AŒ£¡ ~iS~J'~YSI:úS, 'Sou.fuold lðl.CY7
17. If applicant II not tha owner, both must Ilgn the application
I nereDy affirm that information provided on this form and all attachments submItted herewith is true to the best of my knowledge and belief. False statements made here,n
are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. Further. the ap~icant accepts full responsibility for all damage, direct or InOlfec1.
of whate....er nature, and by whomever suffered, arising out of the projed described herein and agreea to Indemnify and Hve hannless the State from suits, actions
damages and costs of ever; name and description resulting from said project. In addition, Federal law, 18 U.S.C., Section 1001 provides for a fine of not more than
510.000 or Imprisonment for not more than 5 years. or both where an appU t k and willingly falsifies, conceals, or covers up a material fact, or knOWingly makes
Of ",e\\'I:;ë¡~US Of llaudulenl slatement.
Date Signature of Applicant Title ~~3'i
Date Signature of Owner Title
.
.
,....,... (12/i17)-q
rROJECT 10 NUMBER
.17.20
·~C
STAn: ENVIRONMENTAl. QUALITY REVIEW
. SHORT ENVIRONMENTAL ASSESSMENT FORM
.. for UNUSTED ACTIONS Only
PART !-PROJECT INFORMATION (To be completed by Applicant or Project Sponsor)
2. PR HAM
VV I'
SEQR
7?:D 1<tiliblt lß.t'le.
~ MtcioY\, NY
Sc.TM
e
.
5. IS PROPOSED AC110N:
a New C Exøanalon ~odlficattonlalt.raUon
6. DESCRIBE PROJECT BRIEFL'f. .
~t\1DV~ aro dl~¡:O~~ of 0.. :44' ~~tioV1 of an ex~i1~q Jet+t¡.
11\'5t!A.lI Q revJ -44' Jet+t¡ l.¥\-Ùrtd I In': Plo.ce USlv\q Cf.A
trm+td YW1k~ili
7. AMOUNT OF LAND AFFECTED:
Inltiolly 0 -- \JIII..-Iy 0 .....
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRIC11ONS?
~.... 0 No hO,cIolCttbobriolly
8. ~T IS PRESENT LAND USE IN VICINITY OF PROJECn
".R__ 0_ 0_ o~
00ICttÞ0:
.
~~haJ \^.kl;k~~n +-
o I'ooIc/FooooIiO Il1*o.
o 0Ih0.
-
1>n"a~
10. DOES AC110N INVOLVE A PERMIT APPROVAL. OR FUNDING. _ OR ULTIMATELY FROM AN'I OTHER GOVERNMENTAl. AGENCY lFedoral. Slat. 0'
~ ?
7J Yo,
o No
If yes. .... agency(a) and petmItIappra..- .
r._,..
Ator<:, I'\'«;>~ NY';:.1)o~,~_w~of 5o"-thol4..·
, 1. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VAUO PERMIT OR APPROVAl.?
o Va .." No " yea. Hat ~ namt and pemUtlappr'O¥aI
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAl. REQUIRE MODIFICATION?
o Yo, ¥No . . .,. .,. . .
Signature
If the .ctlon I. In the CO.....I Ar... .nd you .r. . st.t. .g.ncy, .
compl.t. the Co...... As....m.nt ~rrn b.for. proce.dlng with thl. .....sm.nt
. OVER
.
.
PART II-ENVIRONMENTAL ASSESSMENT rro be completed by Agency)
A. DOES ACTION UCEEO ANY TYPET THRESHOw IN I NY~R PART 117.41
o Yet 0 No .. Yfti, coordinate the revlÞ" DtOCe.. and UN the FULL EAF.
B. WIll. ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTeO ACTIONS IN . NYCRR PART 111.S?
o V.. 0 No .. no. I nealtIve dectar.11on mav bllUDI'rnded by anoth., Involved aoency.
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLl.OWlNG: C......... may be hand_on. llleglblo) .
C 1. Exilllng air qualtty, lurf.C. or groundwll" quality or quantity, not" ...,.ta, .lUlllng traffic ~tt,"", ,oUd wut. production or dilpoul; potlntlal tor .tOllon,
dralna". or tloodll" g prOblema? Explain briefly:
. .
,. .
;'
.'
,
,
,
C2. Ae.thetlc. a"ncultural. .rch..oIoglcal. hll~ric. or other natural or cutturaJ '''QUI'cea: or Community, OI.rte ghborh~..c~.rKtllr? Explain briefly:
I,' .... , '. ¡.'
.
C3. V.gltatlon or fàunl. 'fiah,' ,~,"rlà~~ 'or wlldll," spee,", Ilgr¡itlcanl håbitata. 'or thr.atened or endang.red ¡pecie.? Explain briefly:'
'., I
C4 A community", ..lIIting pl.n. or goal. U onlClally adopted, or. chang. In UN or Inlenatty of UN 01 land or olher natural re.ources? Explain briefly:
, '.
. I! ~ ' . I ¡
CS. GrpwU\. lubMquent d..,elopn;';u. cr "'~tèd IctiYttlt;I Ilk.tv to a Indu~ by the ~ action? explain briefly:
,
..
..
,
. '.
': r
- -
..
.',
I C6. Long term. mort lerm. cumulative. or other efl'1tCIa not tdentIfied In C1-CS? Exp&aJn briefty:
C7. Other irnøactl (Including Changes In UM or .lIMr quanUly or type of energy)? Eap¡aln briefly:
.
O. WIll. THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABUSHMENT OF A CEA?
a v., ONo
E. IS THERE. OR IS THERE UKE\.Y TO BE. CONTIIOVERSY RElATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS?
o Yea 0 No Ir yeI. .xp&a;n brieIty
., .
. .,
PART II-DETERMINATION OF SIGNIFICANCE rro be compteted by Agency)
INSTRUCTION': For each aave,.. effect ldenttfted above. ...~_ whether It illUbIUInUaI. .... knponant Of otMrwlM significant. Each enect ,hould be
u.e.1ed in connection wtlh III Ca) NIUng (I..., urbM or ruraI); (b) PfObUMiIy of occurnng; CC) åUratkIn: (d) ItreYerajblllty; Ie) Q.ographlC .cope;
and (f) magnitude. " necenary. ..:Jd aqach"..". or "'.... ~ppofUnO IQ*rIaIa. IEnIuN tMI.¡pIatÍaUon.· COlGIn Iwftfclinl øe..¡( 10 Ihow thai
.,1 rele.,anl adVe,.. Impacta have bMf'! ktentifIed and adecluaIåIY adcIrnMd. "qUMüon D bf Part II wu checked'Y.I. the d.termlnation· and Ilg.
nificance mUll .valuate the PØlenUallmpact or 1M propoød Mtion on 1M .nWcNanemat CharICIeItIticI of the CEA.
o Check this box if you heve Identified one or more potentially large and significant advtVse Impacts which mey Occur. Then
proceed directly to the FULl EAF and/or prepare a posnlve declaration.
o Check this box if you have determined, baaed on \he Information and analysis above and any supporting documentation.
that the proposed action WILL NOT result In any significant adverse environmental Impacts AND provide on.altachments
as necessary. the reasons supporting this determination:
Name of Lnd Agency'
. . .
.,
Pnnl or Type Name 01 R.sponsiÞle Officer in Lød Ag."".
TIlle 01 Responlible Officer
Signature 01 RelponSlÞle Officer in LeaØ Agency
S¡gnalure or Preparer (II different from relponsible offIcer)
0.'0
.
.
AU'l'IIOIU ZlI'rION FORM
Date: Q-;;24-0 I
'. M-dt--J~ ~n.' o~"Jn~~g!kM,¡J.~
lo.cated at$.J~ Yf)('J~
do herby give Costello Marine contracting Corp. the authority to
act as agent in my behalf in applying for all of the necessary
permits in order for work to be done on my property described
above.
:*~ -£L-
Signature