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:�'��3,� � ".,:�_ .�d���_;;;`'r _ <br /> . , <br /> I have read the permtt and my project is eligible according to the permit Yes <br /> f understand that incomplete applicatlons cannot be processed Yes <br /> 1 am ready to make payment Yas <br /> My proJect Is not taking place withtn the boundary of an fndian reservation Yes <br /> � -,.�•:ca�it�y.�, �,;�„1`�^Q°Ullsl•t_: <br /> � _ __---- -- - ----- - - --- - _ ____ _ - - <br /> Have you implemerrted any prevention activitfes in the past year? Yes <br /> How did you do it? Stamwater Pollution Prevention BMP <br /> Woufd you Ilke to be contacted bo discuss preventlon opportunitfes'T No <br /> 'y.Alil�.[:1��' <br /> Was an environmental review requlred for thls pr�oJect or any part of a common plan o#devebpment or No <br /> sale that Includea this proJecYT <br /> If Yea to�1,is the environmental review proces9 complete? No <br /> tf Yes to#2,please provide the foNowing information: <br /> Responsible governme�rtal unit(e.g.,city,township,county,state or federai agency) <br /> Type of environmental review document <br /> Completion date#or emlronmental review <br /> If Yes to#2,has mitigatfon Identlflad In the emrironmental review bcen incorporated into a atormwater <br /> pollufion prevention plan(SWPPP}? <br /> ���'idii7,���:fi�' '•7��R;PC,�� `_'���„�ai.�4�°J, :?ria -- - - --- <br /> Has a SWPPP been devebped for this project and incorporated Into the project's plans and Yes �E�'���� <br /> speciflcatlons as required In the General Stormwater Permit Part IIIA? <br /> aPR oszo�s <br /> Does your proJect have a discharge point vrithin one mile(asrial radius meaauremerrt)of a special water No <br /> or a water that is Im�ired for sedimerrt or a sediment rela#ed parameter(aee Appendix A, Part B.70)? C�.���� <br /> If your project haa a discharge polnt within one mile(aerlal wadlus meaaurement)of a special water or a Not Applfcab[e <br /> water that is Impalreci for sedimerrt ar a sediment related parameter(see Appendix A, Part B.10),doea the <br /> SWPPP cor�tain the addlttonal requlremerrts found in Appendix A, Parts A-C? <br /> �# 3 � z� � <br />