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09/14/2000 12:34 6517042092 <br />RWMWD <br />PAGE <br />3 <br />venom* Wetland Conarvation Ac <br />ClielTIFICATE or NO LOSS OR EXEXPTVIsis <br />APPLICANT AND PROJECT LOCATION INFORMATION <br />LGU: ?pinky - wash:A. /tr.,. nteiro thrashed <br />Project Location:it_ It__ Li 1f4S 314jj, I/41S <br />trrm Coortlinatom 4/14o qq655.30 <br />County Name/Numbor: Kam le y <br />Major Watorshed NEna/Ntmtban Lott (shaky% <br />Size of ontiro mos ;ea 06 fropte Lim.h <br />Weiland wan Circular 3944.L...; <br />Chock onst)(4014 o SOWS% or sr> oca <br />Check tom C Agricultural land; *Nona. bold <br />• Etol (Se leer <br />Name(*) otApplioant <br />3nCs I pe urctrol 14.1 ASU <br />SIT, /*HP rn1idi ti,) rill 7 <br />City, Stow Zap Coda <br />(f9) 01.-40f7.- <br />Tat/bone (Uay) (Evening) <br />PROPOSED PROJECT DESCRIPTION <br />Describe* Mtn sad purpose MOE proposal project lit m c (ar rin).az 11%. <br />am will 11 / 00 a Ind will be <br />' <br />much saimas Eau atmeD <br />lotad • / / 0 <br />The EWES activity Elm above site mans Ibr the following under the Wetland Conservation Act (WCA) (check ono <br />No Lon Da—'-' ip (mach plats) <br />X uniPtinn b*-1(31(Perhim Lk augur 3420.0122) (Now Appilaart a ramie:Mk* serbonaingilisproqfnecosnry <br />to show quallfiaatlanfir 1¼ stemstie, alatinad) <br />Otscripdon otlIssupdoa Calmat a <br />US min; taps h 2o0o sjy op <br />%mare <br />sivrucANT siGNATuat <br />The isiftaronion provided its this dettrothation j tnithild ES scants to the best of MY knovIladp. t Etsure dun. In draining or MUM <br />the subject watland under ntasempdas noted above, approptialo erosion control measures will W taken to pvatott sedimentation of ma <br />mum flan drain or fill TIM nat block nub pour, sad the dada or fill will be conducted In compliance with all other applicable dara1, <br />state and local raquiressms, inoludina bastmotammtmtpradars sod flair IMMO Dicinion reindrcmcnte efiallthed under MUMS* <br />Capon 1011/1. <br />(Silanno otApplikato (Ds) <br />Non Any opera k at *Oscan as gnats below tre tomplets. Na nark Amid born tetra SW iSstaY Wad windew bas <br />OP <br />the <br />2illi-Clintr=iialLatiLLAWWILTILL Penosang 1004 Me mediae& oiremin mei be niqUiree4 ChMk <br />with 1¼ tfproprae assfrosts b*Int etelletelfelIth work t ar 141140PAIA 77wr Combined haloct Appikadan form can be used <br />fivridaparpora <br />axnaccattor(Nornsem <br />Page 57 <br />• <br />