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HomeMy WebLinkAboutTR-7846A James F. King,President SO(/jTown Hall Annex Bob Ghosio,Jr.,Vice-President `O� �� 54 Main Road y P..O.O. Box 1179 Dave Bergen l� T Southold,New York 11971-0959 John Bredemeyer CA Michael J. Domino :RA �� Telephone(631) 765-1892 Fax(631) 765-6641 �yCOW I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE #0833C Date: December 20, 2012 THIS CERTIFIES that the installation of a generator system on the seaward side of the dwellinv At 590 Tarpon Drive, Southold, New York Suffolk County Tax Map# 57-1-6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 21, 2012 pursuant to which Trustees Administrative Permit#7846A Dated July 18, 2012, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the installation of a venerator system on the seaward side of the dwelling. The certificate is issued to MICHAEL R. WILSON owner of the aforesaid property. Authorized Signature Jill M. Doherty,President �Ur soory Town Hall Annex James F. King,Vice-President ,`O� �� 54375 Main Road P.O.Box 1179 Dave Bergen Southold, New York 11971-0959 Bob Ghosio,Jr. CA �e John Bredemeyer Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: aec- 1 54 7-0 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 151 day of construction '/2 constructed A_ Project complete, compliance inspection. INSPECTED BY: � • COMMENTS: CERTIFICATE OF COMPLIANCE: MICHAEL R. WILSON 590 Tarpon Drive PO Box 870 Southold, NY 11971-0870 Home: (631) 477-4174 Cell: (214) 213-0296 r f December 5, 2012 DEC 10 2012 Town of Southold Trustees - Town Hall Annex Building 54375 Route 25 P.O. Box 1179 Southold NY 11971 Re: Permit#7846A Dear Sirs/Madam: The Generator has now been installed and the project is complete. I will note that the contractor decided that the original location he selected was too close to a window, so moved the planned location a few feet East(towards Route 25). I discussed the change with the Trustees office before the generator was installed and was informed that because the new location was slightly further from the water than planned, no changes to the permit were necessary. Sincerely, Q / �1'4W iJld.. Michael R. Wilson APPROVED B' BOARD OF TRUSTEi TOWN OF JUN 2 1 2012 Southho~d lown Board o! Trustees TARPON :DRIVE TOWN OF SOUTHOLD SLI~' COUNTY N.Y. CHORNO AI~IATES A-,1 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction ~ constructed Project complete, compliance inspection James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7846A Date of Receipt of Application: June 21, 2012 Applicant: Michael R. Wilson SCTM#: 57-1-6 Project Location: 590 Tarpon Dr., Southold Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Trustee Mike Domino Project Description: To install a generator system on the seaward side of the dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the application received on June 21, 2012 and project plan stamped approved on July 18, 2012. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Board of Trustees James F King, President Bob Ghosio, Jr, Vice-Presidenl Dave Bergen John Bredemcycr Michael J. Domino P.O Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: MICHAEL R. WILSON requests an Administrative Permit to install a generator system on the seaward side of the dwelling. Located: 590 Tarpon Dr., Southold. SCTM#57-1-6 Ty~e of area to be impacted: ~,~altwater Wetland Freshwater Wetland Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Sound __Bay ,,,~y~pe of Application: Wetland Coastal Erosion __Amendment Administrative__Emergency --Pre-Submission Violation Info needed: Modifications: Conditions: z ,,~;/.,' ¢/ Pres, cm Were: J. King __B. Ghosio__ / J. Bredemeyer Michael Domino Form filled ou,,t in th/e field by Mailed/Faxed to: Date: D. Bergen, D. Dzenkowski other N souND OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NrY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: MEMORANDUM Jim King, President Town of Southold Board of Trustees JUL ]6 20]2 S0u~hh0]~i ~ov~n From: Mark Terry, Principal Planner LWRP Coordinator Date: July 13, 2012 Re: Proposed Wetland Permit for MICHAEL R. WILSON SCTM#1000-57-1-6 MICHAEL R. WILSON requests an Administrative Permit to install a generator system on the seaward side of the dwelling. Located: 590 Tarpon Dr., Southold. SCTM#57-1-6 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office UseOaly Coastal Erosion Permit Application Wetland Permit Application X Administrative Permit Amendment/Transfer/Extension ~_~Received Application: ,~/o,2 ~( Received Fee $ ~Completed Application {9 !~M ~,~' Incomplete SEQRA Classification: Type 1 Type I1 Unlisted Coordination:(date sent) ~..~--2EWRP Consistency Assessment Form CAC Referral Sent: ~-"Date of Inspection: I~ __Receipt ofCAC Repo~: __Lead Agency Determination: Technical Review: ~dublic Hearing Held: ~ Resolution: 2 1 2012 S0uthh0ld Town B0~rt~ of Trustees Name of Applicant J'l I C~,~6: Address _~al0 5-')q/L~oto ~140~0 ~1~' D q ~ l PhoneNumber:( Suffolk County Tax Map Number: Prope~y Location: ~ ~ O ~g ) ¢~,rT-~oLD N:/ Itq-71 (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: ~d of Trustees Applicatio~ Previous use of property: Intended use of property: Covenants and Restrictions: Land Area (in square feet): Area Zoning: 1~. ~,Or- 0 Yes If "Yes", please provide copy. GENERAL DATA /'~No Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes / No Will this project require any de)molition as per Town Code or as determined by the Building Dept. Yes V/ No / Does the structure (s) on property have a valid Certificate of Occupancy I// Yes __ Prior permits/approvals for site improvements: Agency Date No ~No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend~ by v/ No If yes, provide explanation: a governmental agency? Yes Project Description (use attachments if necessary): B~d of Trustees Applicatio~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~lDf3 G6po~,~/X~FO ~ ~21gfftC-O~7' Area of wetlands on lot: i O square feet Percent coverage of lot: ,O~' % Closest distance between nearest existing structure and upland edge of wetlands: ~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~'~- feet Does the project involve excavation or filling? ~/No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: ~ Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1 APPLICANT / SPONSOR 3.PROJECT LOCATION: 6'17.20 SEQR APPENOIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5 IS PROPOSED ACTION: [] New [] Expansion [] Modification / alteration 5 DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: Initially O acres Ultimately O acres 8. WWIL~L PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes L--J No If no, describe briefly: RAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) esidentia, E~lndustrial [~]Commercia, [---]Agriculture [] Park / Forest / Open Space r~other (describe) lO DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) F-.-~Yes [~No if list name and permit / yes, agency approval: ~1. DC~E~S-~_____~'~:rECT'OF iht AG I ION HAVE A CURRENTLY [~Yes L~No If yes, list agency name and permit / approval: 12. AS ARES~ESJilLT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? Des O I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name t'ltC~ I::U~L I~ J"~J~-~l~ Date: Signature ~.~ , 6/ ~/'~c1 12- If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A i D o z~ ~-~ ~)) ~:~ ~ STORM-WATER, GRADING? DRAINAGE AND EROSION CONTROL PLAN aisl~lct se~.. .lock Lot C~K ~ ~r,~u BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION 1'11~ # / WORK ASSESSMENT I Yes No a. What is the Iota Area of the Project Parcels? I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Paresis located within t ~-~ ~ ~ Generated by a Two (2') Inch Rainfall on SiM? the Scope of Work for Proposed Construction) b. What is the Tctal Area of Land Cleadng (S.F. I Ac~s) ('rhis itsm will include all run-off creatad by site clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed ) ~ ~ Site Improvements and the permanent creation of construction activib/? impervious surfaces.) (s.F.,~) 2 Does the Sita Plan and/or Survey Show AIl Propesed Item shall include all Proposed Grade Changes and -- ~ '~) ~-3"~/',) ~ ~-- J¥~'t~ ~.. j~ ~t~"~C~.~J~j- Slopes Controlling Surface Water Flow. ~'~_) ~.~. (~ J~) ,c5~.~ ~_~ 3 D°es the Site Plan andl°r SurveY descdbe the er°si°n and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Petied. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Ma edal within any Parcel? 5 Will this Application Require Land Disturbing Activities D / Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the Q / Site? Is this project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or are par[ of a larger common plan thai will ullimalely disturb one or more acres o~ land; which Exceed Fifteen (15) feet of Vertical Rise to 2. The SWPPP shall describe the erosion and ssdknent contnd p~actices and where 9Will this Project Require the Placement of Matedal, CONN;~ D. ~UNC; t STATE OF NEW YORK,cOUN~,. OF ~ ' ' ~' t_~-.." ' ..,~..-o..LJ.. ~'~'"?,~T.I, ....................... ,SS Notary Public, State of New Yo~ No. 01BU6185050 ~,.... ^ _ _ . Qualified in Suffolk County ~/, That I, ! .'l_.~..t.t ..b~....~....~...~,,,,......~ ...~........'~....~.~ ~ being duly sworn, de pose s and saysGl~pis'~i~l~O]t ~l~t ~c,,/~i~ And that he/she is the .O....~.~..~. ....................... Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ........ ............... .......................... h,ic: .............. ..................... FORM - 06110 of Trustees Ap~licatio~ County of Suffolk State of New York ~17 c~4 ~&t_ .~ ~ } C~Q5tO BEING DULY 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 HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS ,:~ DAY OF ~,?.-.tx.C ,20 /ok Notary Public CONNIE D. BUNCH Nota~ Public, State of New York NO, 01BU6185050 Commission E)q3ires AprilTM, ", :~- { APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the hart of toWn officers and emt>lovees. The t~uroose of this form is to nrovide information which can alert the town of vossible conflicts of interest and allow it to take whatever action is YOUR NAME: (Last name, first name, ~niddte initial, unless yOU are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5%.~Ahe shares. YES NO ¥ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title Or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __,A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); __B) the legal or beneficial own~:r of any interest in a non-corporate entity (when the applicant is not a corporation); __C) an officer, director, partner, or employee oftbe applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this 20 day of _~u~ ~ 201~ 7__ Signature ~ , -- Print Name ~qte-.~4 t~(c.~ P.. T~wn of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si~.tmificant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suvvorfin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# '3 -~ ~ ) o ~ PROJECT NAME I~lbD)'l~o/'~,,. cDg' ~TANDR~T' ~'&to6'~°/~O/E, The Application has been submitted to (check appropriate response): TownBoard [] Planning Board [~ Building Dept. ~] BoardofTrustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: Present land use: -~ Present zonhg clmsificmion: If ~ application for ~e proposed action h~ been filed wi~ ~e Tom of Sou~old agency, ~e following iffo~ation sh~l be provided: (a) N~e ofapplic~t: (b) Mailing address: (c) Telephone umber: Mea Code ( ) (d) Application umber, iffy:. Will the action be directly ~de~en, req~re ~d~g, or approv~ by a state or federal agency? Yes ~ No ~ If yes, whch stme or federal agency?. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [] Yes [] No [-~/Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria No [ZNot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [--] Y e~ ~-~ No [-~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LwRP Section III- Policies Pages 8 through 16 for evaluation criteria ~Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [] Yes ~-] No ~/Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Ap~able Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~ No ~"~Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~ Yes ~-] NoKT~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~'~ Yes~] No [~/Not Applicable Attach additional sheets if necessary WORKING COAST POLICI~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable Iocations~_~c LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~-~ No I_~ Not Applicable Attach additional sheets if necessa~ Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [] Yes ~ No ~//Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [] Yes [-~ No ~/Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies;/P~ges 65 through 68 for evaluation criteria. [] Yes ~ Nor:7(M Not Applicable PREPAREOBY ylJCl~cL_ ~ k))c~)~~ TITLE ~ON~.~ DATE