Application for a Department of Army Permit

DEPARTMENT OF THE ARMY

CORPS OF ENGINEERS, PORTLAND DISTRICT

P.O. BOX 2946

PORTLAND, OREGON 97208-2946

<DATE>

Regulatory Branch

 

Corps No. NWP-XXXX-XXX

«ADDRESSEE»

Dear «SALUTATION»:

The U.S. Army Corps of Engineers (Corps) received your request for Department of the Army authorization to <<ACTIVITY>>. The project is located IN/NEAR LOCATION in <<City>>, <<County>>, Oregon. The site is in Section XX, Township XX North/South, Range XX East/West.

<<PROJECT DESCRIPTION>> The project is shown on the enclosed drawings (Enclosure 1).

This letter verifies your project is authorized under the terms and limitations of Nationwide Permit (NWP) No. . Your activities must be conducted in accordance with the conditions found in the Portland District NWP Regional Conditions (Enclosure 2) and the NWP General Conditions (Enclosure 3). You must also comply with the Oregon Department of Environmental Quality (DEQ) Water Quality Certification Conditions (Enclosure 4), <<Oregon Department of Land Conservation and Development (DLCD) Coastal Zone Management Concurrence Conditions (Enclosure 5)>>, and the project specific conditions lettered (a) through (X) below. Failure to comply with any of the listed conditions could result in the Corps initiating an enforcement action.

a. Upon starting the authorized activities, you shall notify the U.S. Army Corps of Engineers, Portland District, Regulatory Branch that the work has started. Notification shall be provided by telephone at [PM's Phone Number] or sent by e-mail to [email protected] and the email subject line shall include: Corps No. NWP-2015-XXX and [County] County.

If mitigation is required include this condition (Option 1 for mit. bank and Option 2 for Permittee mitigation):

b. Prior to the first discharge of dredged or fill material into a jurisdictional water of the United States, you shall purchase [NUMBER OF CREDITS] credits from the [NAME OF BANK]. The permittee shall submit proof of this transaction to the U.S. Army Corps of Engineers prior to any discharge of dredged or fill material into a jurisdictional water of the United States.

OR

c. Your responsibility to complete the required compensatory mitigation as set forth in Special Condition <<X>> will not be considered fulfilled until you have demonstrated compensatory mitigation project success and have received written verification of that success from the U.S. Army Corps of Engineers.

We direct your attention to NWP Regional Condition 16 (Enclosure 2) and General Condition 29 (Enclosure 3) that requires the transfer of this permit if the property is sold, and NWP General Condition 30 that requires you to submit a signed certificate when the work is completed. A “Compliance Certification” is provided (Enclosure X).

**IF YOU COMPLETED AN APPROVED JD, IF NOT DELETE THIS PARAGRAPH***

Enclosure <<#>> is the jurisdictional determination (JD) form that identifies the basis for asserting jurisdiction. If you are not in agreement with that approved JD, you can make an administrative appeal under 33 CFR 331. Please see the enclosed Notification of Administrative Appeal Options and Process and Request for Appeal for further information about that process (Enclosure #). This approved JD is valid for a period of five years from the date of this letter unless new information warrants revision of the determination.

**If the Preliminary JD is sent with a verification or authorization letter, the following statement should be included (If PJD already sent, remove this paragraph) **:

We have prepared a Preliminary Jurisdictional Determination (JD), which is a written indication that wetlands and waterways within your project area may be waters of the United States (Enclosure XXX). Such waters have been treated as jurisdictional waters of the United States for purposes of computation of impacts and compensatory mitigation requirements. If you concur with the findings of the Preliminary JD, please sign it and return it to the letterhead address within two weeks. If you believe the Preliminary JD is inaccurate, an Approved JD may be requested, which is an official determination regarding the presence or absence of waters of the United States. The enclosed Notification of Administrative Appeal Options and Process and Request for Appeal describes options regarding Preliminary and Approved JDs (Enclosure #). If you will like an Approved JD, one must be requested prior to starting work within waters of the United States. Once work within waters of the United States has been started, the opportunity to request an Approved JD will no longer be available.

If Blanket JD used for projects with work or structures perpendicular to the shoreline (e.g., piers, ramps, and floats) or away from the shoreline (e.g., buoys, watercraft lifts, dredging) proposed to be authorized in navigable waters and an individual AJD or PJD is not prepared) use:

[WATERBODYNAME] is a water of the U.S. If you believe this is inaccurate, you may request a preliminary or approved jurisdictional determination (JD). If one is requested, please be aware that we may require the submittal of additional information to complete the JD and work authorized in this letter may not occur until the JD has been completed.

This authorization does not obviate the need to obtain other permits where required. Permits, such as those required from the Oregon Department of State Lands (ODSL) under Oregon’s Removal /Fill Law, must also be obtained before work begins. <<INCLUDE FOR NWP 3, 14, 15, 29, 36, 39, OR 42:>>The DEQ water quality certification conditions (Enclosure 4) require you to obtain DEQ approval of your stormwater management plan prior to initiating construction. Please contact the 401 Water Quality Certification Coordinator, Oregon Department of Environmental Quality, 2020 SW Fourth Avenue, Suite 400, Portland, Oregon, 97201-4987, by telephone at (503) 229-6030, or visit http://www.deq.state.or.us/wq/sec401cert/removalfill.htm.

The nationwide permits expire on March 18, 2017. This verification is valid until March 18, 2017 unless the NWP is modified or revoked prior to that date. If you commence or are under contract to commence this activity before the date the NWP expires, is modified, or revoked, you will have 12 months from the date of the expiration, modification, or revocation to complete the activity under the present terms and conditions of the current NWP.

We would like to hear about your experience working with the Portland District, Regulatory Branch. Please complete a customer service survey form at the following address: http://corpsmapu.usace.army.mil/cm_apex/f?p=regulatory_survey.

If you have any questions regarding this NWP verification, please contact <<PM NAME>> at the letterhead address, by telephone at (5**) ***-XXXX, or email [email protected].

FOR THE COMMANDER, JOSE L. AGUILAR, COLONEL, CORPS OF ENGINEERS, DISTRICT COMMANDER:

Shawn H. Zinszer

Chief, Regulatory Branch

Enclosures

Copy Furnished:

Oregon Department of State Lands (RC NAME)

Oregon Department of Environmental Quality (Nayar)

Oregon Department of Land Conservation and Development (Snow and Wade)

**For Nationwide Permits 12, 39, 51, and 52: Send copies to the following address**

Department of Defense Siting Clearing House

Attn: Ms. Cynthia Jester or Mr. David Blalock

Regional Environmental and Energy Office - Southern (REEO-S)

Office of the Assistant Secretary of the Army,

Installations, Energy, and Environment - ASAIEE

200 Westpark Drive, Suite 140

Peachtree City, GA 30269

or

[email protected]

[email protected]

**For Nationwide Permit 12 involving utility lines in Navigable waters that need charting: Send copies to the following address**

NOAA’s National Ocean Service

[email protected] or [email protected]

Corps Civil Works Channels and Harbors

[email protected]

Corps ID No: _________________

REQUEST FOR PERMIT TRANSFER PER GENERAL CONDITION 29

When the structures or work verified by this nationwide are still in existence at the time the property is transferred, and/or a new party obtains this permit verification, the terms and conditions of this permit will continue to be binding on the new permittee. The new permittee should sign and date below to accept the liabilities associated with complying with the terms and conditions of this permit verification, and to validate its transfer.

PERMIT TRANSFEREE:

_____________________________________ ______________________

Signature DATE

_____________________________________

Name (Please print)

_____________________________________

Street Address

_____________________________________

City, State, and Zip Code

NEW OWNER (if applicable):

_____________________________________ ________________________

Signature DATE

______________________________________

Name (Please print)

_____________________________________

Street Address

_____________________________________

City, State, and Zip Code