DEPARTMENT OF THE ARMY JACKSONVLLE DSTRCT CORPS OF ENGNEERS 1520 ROYAL PALM SQUARE BOULEVARD, SUTE 310 FORT MYERS, FLORDA 33919 REPLY TO ATTENTON OF February 6, 2013 Regulatory Division Fort Myers Section SAJ200700410(NWKDS) Florida Fish & Wildlife Conservation Commission R. S. Wilder, P.E. 620 South Meridian Street Tallahassee, Florida 323991600 Via email: Randy.Wilder@MyFWC.com Dear Mr. Wilder: Your application for a Department of the Army permit received January 31, 2013, has been assigned number SAJ200700410(NWKDS). A review of the information and drawings provided shows the proposed work is the replacement of the eisting low water crossing with five bo culverts requiring 36 cubic yards of fill. The total project area is 0.018 acres. The project is located in the Roberts Canal, within Spirit of the Wild Wildlife Management Area, in Section 21, Township 44 S, Range 29E, Hendry County, Florida. Latitude 26.6362 N and longitude 81.4240 W. Your project, as depicted on the enclosed drawings, is authorized by Nationwide Permit (NWP) Number 14. n addition, project specific conditions have been enclosed. This verification is valid until February 6, 2015. Please access the U.S. Army Corps of Engineers' (Corps) Jacksonville District's Regulatory webpage to access web links to view the Final Nationwide Permits, Federal Register Vol. 77, dated February 21, 2012, specifically pages 10270 10290, the Corrections to the Final Nationwide Permits, Federal Register 77, March 19, 2012, and the List of Regional Conditions. The website address is as follows: http:www.saj.usace.army.mildivisionsregulatorysourcebook.htm. Please be aware this web address is case sensitive and should be entered as it appears above. Once there you will need to click on Nationwide Permits. These files contain the description of the Nationwide Permit authorization, the Nationwide Permit general conditions, and the regional conditions, which apply specifically to this verification for NWP 14. Enclosed is a list of the si General Conditions, which apply to all Department of the Army authorizations. You must comply with all of the special and general conditions and any project specific condition of this authorization or you may be subject to enforcement action. n the event you have not completed construction of your project within the specified time limit, a separate application or reverification may be required.
2 The following special conditions are included with this verification: 1. Selfcertification of Compliance: Within 60 days of completion of the work authorized, the attached SelfCertification Statement of Compliance must be completed and submitted to the U.S. Army Corps of Engineers. Mail the completed form to the Regulatory Division, Special Projects and Enforcement Branch, 1520 Royal Palm Square Boulevard, Suite 300, Fort Myers, Florida 33919. 2. Assurance of Navigation: The Permittee understands and agrees that, if future operations by the United States require the removal, relocation, or other alteration, of the structures or work herein authorized, or if, in the opinion of the Secretary of the Army or his authorized representative, said structure or work shall cause unreasonable obstruction to the free navigation of the navigable waters, the Permittee will be required, upon due notice from the U.S. Army Corps of Engineers, to remove, relocate, or alter the structural work or obstructions caused thereby, without epense to the United States. No claim shall be made against the United States on account of any such removal or alteration. 3. Cultural ResourcesHistoric Properties: a. No structure or work shall adversely affect impact or disturb properties listed in the National Register of Historic Places (NRHP) or those eligible for inclusion in the NRHP. b. f during the ground disturbing activities and construction work within the permit area, there are archaeologicalcultural materials encountered which were not the subject of a previous cultural resources assessment survey (and which shall include, but not be limited to: pottery, modified shell, flora, fauna, human remains, ceramics, stone tools or metal implements, dugout canoes, evidence of structures or any other physical remains that could be associated with Native American cultures or early colonial or American settlement), the Permittee shall immediately stop all work in the vicinity and notify the Corps. The Corps shall then notify the Florida State Historic Preservation Officer (SHPO) and the appropriate Tribal Historic Preservation Officer(s) (THPO(s)) to assess the significance of the discovery and devise appropriate actions. c. A cultural resources assessment may be required of the permit area, if deemed necessary by the SHPO, THPO(s), or Corps, in accordance with 36 CFR 800 or 33 CFR 325, Appendi C (5). Based, on the circumstances of the discovery, equity to all parties, and considerations of the public interest, the Corps may modify, suspend or revoke the permit in accordance with 33 CFR Part 325.7. Such activity shall not resume on nonfederal lands without written authorization from the SHPO and the Corps. d. n the unlikely event that unmarked human remains are identified on nonfederal lands, they will be treated in accordance with Section 872.05 Florida Statutes. All work in the vicinity shall immediately cease and the Permittee shall immediately notify the medical eaminer, Corps, and
3 State Archeologist. The Corps shall then notify the appropriate SHPO and THPO(s). Based, on the circumstances of the discovery, equity to all parties, and considerations of the public interest, the Corps may modify, suspend or revoke the permit in accordance with 33 CFR Part 325.7. Such activity shall not resume without written authorization from the State Archeologist, SHPO and the Corps. e. n the unlikely event that human remains are encountered on federal or tribal lands, or in situations where Archaeological Resources Protection Act of 1979, or Native American Graves Protection Repatriation Act of 1990 applies, all work in the vicinity shall immediately cease and the Permittee immediately notify the Corps. The Corps shall then notify the appropriate THPO(s) and SHPO. Based, on the circumstances of the discovery, equity to all parties, and considerations of the public interest, the Corps may modify, suspend or revoke the permit in accordance with 33 CFR Part 325.7. After such notification, project activities on federal lands shall not resume without written authorization from the Corps, andor appropriate THPO(s), SHPO, and federal manager. After such notification, project activities on tribal lands shall not resume without written authorization from the appropriate THPO(s) and the Corps. 4. Erosion Control: Prior to the initiation of any work authorized by this permit, the Permittee shall install erosion control measures along the perimeter of all work areas to prevent the displacement of fill material outside the work area. mmediately after completion of the final grading of the land surface, all slopes, land surfaces, and filled areas shall be stabilized using sod, degradable mats, barriers, or a combination of similar stabilizing materials to prevent erosion. The erosion control measures shall remain in place and be maintained until all authorized work has been completed and the site has been stabilized. 5. Fill Material: The Permittee shall use only clean fill material for this project. The fill material shall be free from items such as trash, debris, automotive parts, asphalt, construction materials, concrete block with eposed reinforcement bars, and soils contaminated with any toic substance, in toic amounts in accordance with Section 307 of the Clean Water Act. This letter of authorization does not give absolute Federal authority to perform the work as specified on your application. The proposed work may be subject to local building restrictions mandated by the National Flood nsurance Program. You should contact your local office that issues building permits to determine if your site is located in a floodprone area, and if you must comply with the local building requirements mandated by the National Flood nsurance Program. f you are unable to access the internet or require a hardcopy of any of the conditions, limitations, or epiration date for the above referenced NWP, please contact Krista Sabin by telephone at (239) 3341975 etension 31. Thank you for your cooperation with our permit program. The Corps Jacksonville District Regulatory Division is committed to improving service to our customers. We strive to perform our duty in a friendly and timely manner while working to preserve our environment. We invite you to take a few minutes to visit
4 http:per2.nwp.usace.army.milsurvey.html and complete our automated Customer Service Survey. Your input is appreciated favorable or otherwise. Again, please be aware this web address is case sensitive and should be entered as it appears above. Sincerely, Digitally signed by SABN.KRSTA.DAWN.1365953224 DN: c=us, o=u.s. Government, ou=dod, ou=pk, ou=usa, cn=sabn.krsta.dawn.1365953224 Date: 2013.02.06 14:52:21 05'00' Krista Sabin Project Manager Enclosures: Attachment A Permit Drawings Copies Furnished: CESAJRDPE
GENERAL CONDTONS 33 CFR PART 320330 PUBLSHED FEDERAL REGSTER DATED 13 NOVEMBER 1986 1. The time limit for completing the work authorized ends on date identified in the letter. f you find that you need more time to complete the authorized activity, submit your request for a time etension to this office for consideration at least one month before the above date is reached. 2. You must maintain the activity authorized by this permit in good condition and in conformance with the terms and conditions of this permit. You are not relieved of this requirement if you abandon the permitted activity, although you may make a good faith transfer to a third party in compliance with General Condition 4 below. Should you wish to cease to maintain the authorized activity or should you desire to abandon it without a good faith transfer, you must obtain a modification of this permit from this office, which may require restoration of the area. 3. f you discover any previously unknown historic or archeological remains while accomplishing the activity authorized by this permit, you must immediately notify this office of what you have found. We will initiate the Federal and state coordination required to determine if the remains warrant a recovery effort of if the site is eligible for listing in the National Register of Historic Places. 4. f you sell the property associated with this permit you must obtain the signature of the new owner in the space provided and forward a copy of the permit to this office to validate the transfer of this authorization. 5. f a conditioned water quality certification has been issued for your project, you must comply with the conditions specified in the certification as special conditions to this permit. For your convenience, a copy of the certification is attached if it contains such conditions. 6. You must allow a representative from this office to inspect the authorized activity at any time deemed necessary to ensure that it is being or has been accomplished in accordance with the terms and conditions of your permit.
SEARS RD App. 1212038 S SR29 FDOT, Rel. 2011 HENDRY COUNTY, FLORDA Legend Application Application Number: 1212038 Map Date: 20130104 Permit Number: 2600220S04 75 Sec 2123,2528,3336 Twp 44 Rge 29 Project Name: SPRT OF THE WLD WLDLFE MANAGEMENT AREA 0 0.25 0.5 Miles Ehibit Number: 1
... '\ EHBT 2.2 APPLCATON 1212038 Page 1 of 4 N26'38'10.7 SPRT OF THE WLD W8f25'26.S 821 T 44S R29E WLDLFE Quad Name: SEARS Properly Entrance: CR832KER RD MANAGEMENT AREA ROBERTS CANAL CROSSNG \.. SOlfTH REGON JElCJRY COLNTY SCOPE OF PROJECT SCOPE OF WORK. CONTRACTOR TO NSTALL CANAL CROSSNG WTH BO CUL VERTS AND HEADWALLS AS SHOWN N PLANS. PROJECT TO NCLUDE ALL MATERALS, EQUPMENT, LABOR, BONDS, AND NSURANCE NECESSARY TO COMPLETE THE PROJECT. CONTRACTOR TO REMOVE ALL UNUSED MATERALS FROM PROPERTY AND DSPOSE OF N A LEGAL MANNER. NDE OF DRA Gl00 COVER SHEET Cl00 STE PLAN Cl0l BO CULVERT SECTlONS Cl02 GENERAL NOTES OR GNAL SUBMTTAL PROPOSED DEC 0 3 20 1l PROJECT LOCATON ( J t APDUJ\',,,..,. 'Ueo 1 212038. p, H N E cl, r ;; ;!, FLORfJA FSH ANfJ fllj)jfe CONSERVATON CONfSSON... o.1t 1112912 OFfiCE OF PUBLC ACCESS ANJ TmJJ1JTi'E VEflNC SERVCES PLANNNG AND DESGN SECTON JRO SQuib hrldjluj traol '1'a.lalu>_. 1'f. :til3li1f1ttloo (StJD) JU:JJ (..L.... j... :; ;:;,,,' DAn;:
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., ' ' ',.O'.. T, f) ro SHEET C ClOD EHBT 2.2 APPLCATON 1212038 Page 3 of 4 1, ' 8.0' 11 E::, \v'ng\v'all, t J.t 14.0' D :. t:1m', FU: 12' ROAD BASE o C\J 1 1, = 1, m'.. '! HEAD'w'ALL t < >. ' :',> ' :.'(.::::: :', >'. :J;:'!,.k.': >; :<;::,:,:'., : 0,; :, :'. '., o f) FLOW FLOW ' '' ' ' ::': ':: '''': ''' \ BO CULVERT,, l U:,. \, r! i L.,. ={ ',_,,!,. 1. 1' 1,Ji, 1,,, 40.0' r 12' ROAD BASE HEADW'ALL... ' 1, :, ' 1 i,.,. J, ', 0 lfi +1 EL 23.00 J 1. ': il.jl J,,:, _,F _,!: ;!:, 7>...A' :A 7>...A'7>...A'7>...A'7>...A'7>...A'7>...A'7>...A'7>...A':AJ:AJ7>...A':A:AJ:AJ:AJ:AL:AL:AL:AL7>...A' 7>...A' 7>...A' 7>...A' 7>...A' \, '. r ;,. r'.!,.. r O,1 > r ', 1 1, h, '. '101;. Ti3i. _ ' FlORlJA FSH ANJ YlJ)JJFE CONSERVATON COj{}J]SSON ' omce Of PUBliC ACCESS ANJ) ffllj)f1fe VmNC SERrCES PLANNNG AND DESGN SECTON Soutb MendAD Street hljab_. FL 3R3t»11JOD 6' #57 STONE BASE r,.u. c:: CTn,r TlACr.. \... 8,0'... BO CULVERTS Jrofl A:. t!sj[ OAT: 1 11 29, 12 ''''' RSW DAn: OrM RSW STAl[ PAOLt'T No.!., f)...0... 2.0' ' ORGNAL SUBMTTAL APUArt'..,.'f'f!e DEC 0 3 2012 1212038 S>aT nlle SPRT OF THE WLD WLDLFE MANA GEMEN BO CULVERT SECTlONS ROBERTS CANAL CROSS1NG
EHBT 2.2 APPLCATON 1212038 SAJ200700410(NWKDS) Attachment A: Plans Page 5 of 5,..: p, r..j E i) Page 4 of 4 t.,1.., 'fllj}!jj' VEHG SERY.lCES no $0 u tb JrfdlAJ2 Stret TalJab_.., FL :!R:JllflltJOO PLANNNG AND DESGN SECTON OfJ1CE Of PURfJe ACCESS ANJ) FLORJA FSH ANlJ lfllfjjfe CONSERVATON COMMiSSON 5. F WND EROSON BECOMES SGNFCANT DURNG CONSTRUCTON, THE CONTRACTOR SHALL STABLZE THE AFFECTED AREA USNG SPRNKLlNG, RRGATON OR OTHER ACCEPTABLE METHODS. 4. FLL MATERAL STOCKPLES SHALL BE PROTECTED AT ALL TMES BY ONSTE DRANAGE CONTROLS WHCH PREVENT EROSON OF THE STOCKPLED MATERAl. CONTROl OF DUST FROM SOL STOCKPLES S REQURED. 3. All SEDMENT AND EROSON CONTROL MEASURES TO PREVENT SLTATON OF ADJACENT PROPERTY, STREm, WETLANDS, AND WATERWAYS SHAll BE NSTALLED AND MANTANED N ACCORDANCE WTH STATE AND FEDERAL REGULATONS REGARDLESS OF THE MEASURES SHOWN OR NOT SHOWN ON THE PLANS. 2. CONTRACTOR SHALL BE RESPONSBLE FOR THE PREVENTON OF DOWNSTREAM TURBDTY SLTATON THROUGH THE USE OF HAY BALES, SCREENS, SLTATON BASNS, CHEMCAL FLOCCULATON ANDOR ANY OTHER SUTABLE MEANS REQURED TO MEET FLORDA AND FEDERAL STREAM STANDARDS. SEED AND MULCH ALL DSTURBED AREAS, SOD AS REQURED TO CONTROL EROSON THROUGH FNAL NSPECTON AND TO PRODUCE A UNFORM STAND OF GRASS THROUGHOUT. 1. CONTRACTOR SHALL PROVDE AND MANTAN ADEQUATE EROSON AND TURBDTY CONTROLS DURNG AND FOLLOWNG CONSTRUCTON UNTL ALL DSTURBED AREAS HAVE BEEN STABLZED TO AVOD ADVERSE ENVRONMENTAL MPACTS TO OFFSTE PROPERTY AND DRANAGE SYSTEMS. EROSON CONTROL 3. THERE SHALL BE A MNMUM FOUR (4) DAYS NOTCE GVEN FOR SCHEDULNG THE FNAL NSPECTON. 2. THE OWNER SHALL BE GVEN A MNMUM FOUR (4) DAYS NOTCE OF ALL MEETNGS AND OR TESTNG MEASURES RELATED TO SAD PROJECT. 1. A COpy OF THE CONTRACTORS GENERAL LCENSE ANDOR UNDER GROUND UTLTY LCENSE SHALL BE PROVDED AT THE TME OF THE PRECONSTRUCTON CONFERENCE. MEETNGS 9. THE CONTRACTOR SHALL NOT PROVDE ACCESS TO PARTES OTHER THAN THOSE PERFORMNG ACTVTES ASSOCATED WTH THS PROJECT. 8. THE CONTRACTOR SHALL COORDNATE ALL CONSTRUCTON AND BULDNG PLACEMENT WTH ALL OTHER UTlTES AND STE CONSTRUCTON ACTVTES. 7. LOCATONS, ELEVATONS, AND DMENSONS OF ESTNG UTLTES, STRUCTURES AND OTHER FEATURES ARE SHOWN ACCORDNG TO THE BEST NFORMATON AVALABLE AT THE TME OF PREPARATON OF THESE PLANS. T S THE RESPONSBLTY OF THE CONTRACTOR TO CONFRM, N THE FElD, THE LOCATONS AND elevatons SHOWN PROR TO THE COMMENCEMENT OF CONSTRUCTON. CONTRACTOR SHALL VERFY THE ACCURACY OF THE PROVDED SURVEY NFORMATON TO HS SATSFACTON. CONTRACTOR S SOLelY RESPONSBLE FOR PROPER VERTCAL AND HORZONTAL ALGNMENT OF CONSTRUCTED FACLTES, PPELNES, AND FNSHED GRADE. 6. ANY POTENTAL RRGATON OR DEWATERNG WATER RESOURCE SSUES MUST BE PERMlmD THROUGH THE WATER MANAGEMENT DSTRCT PROR TO NTATNG RRGATON OR DEWATERNG ACTVTES FOR THS PROJECT. THE CONTRACTOR SHALL BE RESPONSBLE FOR OBTANNG THESE PERMTS, F NECESSARY. 5. T S THE CONTRACTOR'S RESPONSBLTY TO BECOME FAMLAR WTH THE PERMT AND NSPECTON REQUREMENTS SPECFED BY THE VAROUS GOVERNMENTAL AGENCES AND THE OWNER. THE CONTRACTOR SHALL OBTAN ALL NECESSARY PERMTS AND NSURANCE REQURED FOR THE PROJECT PROR TO CONSTRUCTON. THE CONTRACTOR SHALL SCHEDULE NSPECTONS ACCORDNG TO AGENCY NSTRUCTONREQUREMENTS. 4. THE CONTRACTOR SHALL BE RESPONSBLE FOR REMOVALDSPOSAL OF ANY UNSUTABLE MATERAL FROM HS OPERATON, FURNSHNG AND COMPACTNG SUTABLE REPLACEMENT BACKFLL MATERAL N ACCORDANCE WTH FEDERAL, STATE, AND LOCAL REGULATONS. 3. THE CONTRACTOR S RESPONSBLE FOR NSPECTNG THE STE PROR TO BDDNG AND NCLUDNG ALL SERVCES, EQUPMENT, AND MATERALS NECESSARY FOR CONSTRUCTON. 2. elevatons BASED ON SURVEY PROVDED BY JOHNSON ENGNEERNG, NC. PHONE: 8663674400. 1. All WORK AND MATERALS SHALL BE N COMPLETE ACCORDANCE WTH ALL RELATVE COUNTY STANDARDS AND REQUREMENTS. GENERAL NOTES: THERE ARE TO BE NO OPEN TRENCHES LEFT AT THE END OF THE DAY. ALL MATERAL USED FOR BACKFill SHALL BE USDA STRUCTURAL SOLS.»... 1..nAL. 1S!lJt DATt: \l'doh _ OA 1 1129,112 ST'ATE CQF. MA... RSW CT 1tc. pw f. No. n Jl'Eg(l{ER, 1 8. THE CLEARNG CONTRACTOR WLL CLEAR, GRUB, AND DSPOSE OF ALL DEBRS AND SURFACE ORGANCS TO FRM MATERAL. DSPOSAL SHALL BE NCLUDED N THE CONTRACT PRCE. 7. ALL CONSTRUCTON LNES & GRADES SHALL BE ESTABLSHED AND MANTANED BY THE CONTRACTOR. 6. 5. LlMEROCK BEARNG RATOS (LBR) FOR SUBGRADE ARE FORTY (40) AND lmerock OR ALTERNATVE BASE COURSE ARE ONE HUNDRED (100). THERE WLL BE NO UNDER TOLERANCE. 4. All WORK SHOULD RESULT N A SMOOTH DRVE SURFACE FREE OF SAND RUTS, WHEEL RUTS, GRASS, AND POTHOLES, AND SUTABLE FOR PASSAGE BY CARS. 3. THE FNAL DRVEWAY AND PARKNG AREAS WLL BE FNSH GRADED AND COMPACTED TO A DENSTY OF 95%. 2. DRVE AREA Will BE GRADED (EDGETOEDGE) TO SMOOTH THE SURFACE, FLL ESTNG DEPRESSONS AND REMOVE GRASS AND DEBRS. 1. F NECESSARY, THE CONTRACTOR WLL REMOVE ESTNG VEGETATON THAT S GROWNG N THE PROPOSED DRVE AREA. SPEOFCATONS FOR DRVE AREA CONSTRUCTON 6. CONTRACTOR S TO PROVDE A 12 TO 1 BTUMNOUS EPANSON JONT MATERAL WTH SEALER AT ABUTMENTS OF CONCRETE WTH OTHER MATERALS (STRUCTURES OR OTHER POURED)UNLESS OTHERWSE SPECFED. 5. ALL CONCRETE SHALL HAVE A MNMUM COMPRESSVE STRENGTH OF 5,500 PS (28 DAY STRENGTH), UNLESS OTHERWSE NDCATED, AND SHALL BE CONSTRUCTED N ACCORDANCE WTH AC STANDARDS. 4. 3. ALL ROADWAYS, DRVEWAYS, AND BULDNG PAD LOCATONS SHOULD BE PROOF ROlLED PROR TO MPORTATON OF ADDTONAL FLL OR SUBBASE MATERAL (limerock OR CRUSHcRETE). N THE EVENT THAT PROPOSED COMPACTON AND DENSTES CANNOT BE ACHEVED, CONTRACTOR SHALL NOTFY OWNER WTH A RECOMMENDATON TO ADDRESS THE SSUE. 2. TEMPORARY CONTROL OF GROUNDWATER SHOULD FOllOW THE RECOMMENDATONS OF THE GEOTECHNCAL REPORT AND MAY REQURE PERMTS. ANY DEWATERNG PERMTS ARE THE RESPONSBLTY OF THE CONTRACTOR. 1. USE OF ANY MATERALS ClASSFED BY THE USDA AS UNSUTABLE SHOULD NOT BE USED AS FLL SOL UNLESS A METHOD OF MAKNG THE MATERAL SUTABLE S APPROVED BY THE CLENT. CONSTRUCTON ACTVTES 3. THE CONTRACTOR SHALL BE RESPONSBLE FOR THE PREVENTON OF THE POLLUTON OF NATURAL AREAS BY FUEl, OLS, CHEMCALS, OR OTHER HARMFUL MATERALS. 2. THE CONTRACTOR WLL BE RESPONSBLE FOR ACTONS AND DAMAGES CAUSED BY THER PERSONNEL WHLE ON STATEOWNED LAND. THE CONTRACTOR WLL ALSO BE RESPONSBLE FOR DAMAGE OR DESTRUCTON TO STATEOWNED, LEASED, OR MANAGED PROPERTY OR EQUPMENT CAUSED BY THE CONTRACTOR'S EMPLOYEES OR SUBCONTRACTORS. THS NCLUDES DAMAGE TO ESTNG ROADWAYS, CU LVE RTS, GATES, TREES, NATVE VEGETATON, WLDLFE, AN 0 OTHER NATURAL RESOURCES AND EQUPMENT. 1. UPLAND BUFFERS ADJACENT TO WETLANDS ARE TO REMAN NATURAL, VEGETATED, AND UNDSTURBED. THE CONTRACTOR WLL BE THE RESPONSBLE PARTY N THE EVENT THAT THERE S AN UNAUTHORZED MPACT TO UPLAND BUFFERS. SENSTVE AREAS 7. ALL SDESLOPES SHALL BE STABLZED WTH ESTABLSHED GRASS AT TME OF FNAL NSPECTON AND FREE OF EROSON CHANNELS. 6. All AREAS DSTURBED BY CONSTRUCTON SHAll RECEVE GRASS SEED, FERTlLZER, AND MULCH OR SOD. AREAS SHALL BE FLLED AND GRADED AS NECESSARY TO PROVDE PROPER DRANAGE. SLOPES STEEPER THAN 4:1 SHALL BE SODDED. ALL AREAS DSTURBED N COUNTY OR STATE RGHTOFWAYS SHALL BE SODDED. ntl r Rtl.t:cnnr St T 1212038 APPU, u.t,,,eee ROBERTS CANAL CROSSNG GENERAL NOTES SPRT Or: THE WLD 'MLDLFE MANAGEMENT AREA DEC 0 3 2012 ORGNAL SUBMTTAL oj
SELFCERTFCATON STATEMENT OF COMPLANCE Permit Number: NW14 Application Number: SAJ200700410(NWKDS) Permittee s Name & Address (please print or type): Telephone Number: Location of the Work: Date Work Started: Date Work Completed: Description of the Work (e.g., bank stabilization, residential or commercial filling, docks, dredging, etc.): Acreage or Square Feet of mpacts to Waters of the United States: Describe Mitigation completed (if applicable): Describe any Deviations from Permit (attach drawing(s) depicting the deviations): ******************** certify that all work, and mitigation (if applicable) was done in accordance with the limitations and conditions as described in the permit. Any deviations as described above are depicted on the attached drawing(s). Signature of Permittee Date
DEPARTMENT OF THE ARMY PERMT TRANSFER REQUEST PERMT NUMBER: SAJ200700410(NWKDS) When the structures or work authorized by this permit are still in eistence at the time the property is transferred, the terms and conditions of this permit will continue to be binding on the new owner(s) of the property. Although the construction period for works authorized by Department of the Army permits is finite, the permit itself, with its limitations, does not epire. To validate the transfer of this permit and the associated responsibilities associated with compliance with its terms and conditions, have the transferee sign and date below and mail to the U.S. Army Corps of Engineers, Enforcement Section, Post Office Bo 4970, Jacksonville, FL 322320019. (TRANSFEREESGNATURE) (SUBDVSON) (DATE) (LOT) (BLOCK) (STREET ADDRESS) (NAMEPRNTED) (MALNG ADDRESS) (CTY, STATE, ZP CODE)