HomeMy WebLinkAbout20-26W EvergreenWalk Culvert Rehabilitation
Town of South Windsor | Inlands Wetlands, Watercourses, and Conservation Application
APPENDIX A:
CTDEEP Inland Wetlands
Reporting Form
rev. 12/2016 pdf
79 Elm Street • Hartford, CT 06106-5127 www.ct.gov/deep Affirmative Action/Equal Opportunity Employer
Statewide Inland Wetlands & Watercourses Activity Reporting Form
Please complete and mail this form in accordance with the instructions on pages 2 and 3 to:
DEEP Land & Water Resources Division, Inland Wetlands Management Program, 79 Elm Street, 3rd Floor, Hartford, CT 06106
Incomplete or incomprehensible forms will be mailed back to the inland wetlands agency.
PART I: Must Be Completed By The Inland Wetlands Agency
1.DATE ACTION WAS TAKEN: year: ______________month: ______________
2.ACTION TAKEN (see instructions, only use one code): ______________
3.WAS A PUBLIC HEARING HELD (check one)? yes no
4.NAME OF AGENCY OFFICIAL VERIFYING AND COMPLETING THIS FORM:
(print name)(signature) ________________________________________________
PART II: To Be Completed By The Inland Wetlands Agency Or The Applicant
5.TOWN IN WHICH THE ACTION IS OCCURRING (print name): ______________________________________________________
does this project cross municipal boundaries (check one)? yes no
if yes, list the other town(s) in which the action is occurring (print name(s)): ____________________, ______________________
6.LOCATION (see instructions for information): USGS quad name: _____________________________ or number: __________
subregional drainage basin number: _______________________
7.NAME OF APPLICANT, VIOLATOR OR PETITIONER (print name): __________________________________________________
8.
9.ACTIVITY PURPOSE CODE (see instructions, only use one code): ___________
10.ACTIVITY TYPE CODE(S) (see instructions for codes): __________, __________, __________, __________
11.WETLAND / WATERCOURSE AREA ALTERED (must provide acres or linear feet):
12.UPLAND AREA ALTERED (must provide acres): ____________ acres
13.AREA OF WETLANDS / WATERCOURSES RESTORED, ENHANCED OR CREATED (must provide acres): ____________ acres
DATE RECEIVED: PART III: To Be Completed By The DEEP DATE RETURNED TO DEEP:
FORM COMPLETED: YES NO FORM CORRECTED / COMPLETED: YES NO
GIS CODE #: ____ ____ ____ ____ ____ ____ ____ ____ ____
For DEEP Use Only
NAME & ADDRESS / LOCATION OF PROJECT SITE (print information): _______________________________________________
briefly describe the action/project/activity (check and print information): temporary permanent description: ____________
_______________________________________________________________________________________________________________________
wetlands: ____________ acres open water body: ____________ acres stream: ____________ linear feet
South Windsor
Manchester 38
Evergreen Walk Lifestyle Center, LLC
by POAG Shopping Centers, LLC
Rehabilitation of 3 Culverts at Evergreen Walk
Rehabilitation of 3 Culverts, paving roadway, patching sidewalks, painting existing galvanized culvert ends (rollers only), installing riprap at eroded
channel embankments, and replacing undersized area drains that current do not have outlet treatments before entering wetlands.
0.00
(within regulated buffer)
Town of South Windsor | Inlands Wetlands, Watercourses, and Conservation Application
APPENDIX B:
Certified Soil Scientist
Wetland Report
May 11, 2020
PERMIT PLANS