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MA-02622-01 <br />C►mm..eilime <br />Teta1 length (feet) - - - - - - - <br />Longo in lawatremm (feet)- - - <br />settr VWth (feet) - - - - - - - <br />sift SAMP t IPMWO) - - - - - - <br />Average depth (foot)- - - - - - - <br />Gradient (9) - - - - - - - - - - <br />Aaistise <br />(•-s4) <br />COMINIM014 DATA Woo attach ok*Wh or d mp(V) (Rev 74) <br />proposed Alterations alone she" trepeaN <br />Distance along sAoee (feet)- - - - - -- <br />Distance waterward (,let)- - - - - - -�� <br />Thickness of fill material (feet)- - - <br />Depth Of exCAYit►On (feet) - - - - - - D <br />1. OeseriM type of � ion equipment to he used, if known: <br />�k O <br />2. Describe location ({no rasp) and characteristics of spoil disposal site proposed, <br />'74- <br />3. )Would maintenenee excavation be necessary? (ohook) Q YES C311P-N�o Explain <br />e. Volts of material to be removed initially (cubic yards): Awk or silt <br />Sod <br />or gravel (v Rock or stone O <br />ATTAO:Nffs 0 SIS.00 filing fee, Q photographs, Q other 'ffl.vo�iju) <br />Afflitamt declares that information submitted herewith and statements made herein are a true and correct <br />replo mtation of the facts, and that the filing of this appl uati.,n and information with the <br />Commissioner of Natural Resources is prise facie evidence of the orrectnes% rhareof. <br />0"LlTE APPLICATION SUBM-17ED 10, <br />cl) 0ko <br />4of city own r to• p ----- <br />Ar, kt _ <br />street a poet Office <br />Lee <br />(Z) 14 14 <br />vmw o .k:t,rrs ie Hatrtct --- <br />(S) Shorela Management Admini tutor I <br />of /✓ — _ County <br />Dated this l J� 'lay of <br />S i tned <br />4kei 19&— <br />(applioant) <br />Addrrs+ <br />City <br />State � Zip code 5—S71 7i <br />ss. county of AFFIDAVIT Phone <br />) — <br />on this day, 19�� before me personnally appeared <br />who being first duly sworn a to me known to be thr person wbb ctecuted the foregoing <br />app11catios, acknowledges) that executed the same rs o" free act and deed and <br />that the statements, maps, plans, documents, and other support-ia '^ta are true and correct according <br />to vest knowledge and belief. <br />Count, <br />Ay ;Ono :s;i a..c;.:: _ g <br />`mac --� i-7 ,7 -- <br />