4 DEQ: Permit application fees required for Virginia Water Protection permits while detailed in 9VAC25-20 - are conveyed to the applicant by the applicable DEQ office (http:/www. deq. virginia. gow/Locations. aspx). Complete the Permit Application Fee Form and submit it per the instructions to the address listed on the form. Instructions for submitting any other fees will be provided to the applicant by DEQ staff. * VMRC: An application fee of $300 may be required for projects impacting tidal wetlands, beaches and/or dunes when VMRC acts as the LWB. VMRC will notify the applicant in writing ifthe fee is required. Permit fees involving subaqueous lands are $25.00 for projects costing $10,000 or less and $100 for projects costing more than $10,000. Royalties may also be required for some projects. The proper permit fee and any required royalty is paid at the time of permit issuance by VMRC. VMRC staff will send the permittee a letter notifying him her of the proper permit fees and submittal requirements. * LWB: Permit fees vary by locality. Contact the LWB for your project area or their website for fee information and submittal requirements. Contact information for LWBs may be found at hp.semvimislwnmiy web/guidancelocal wetlands boards. html. FOR AGENCY USE ONLY Notes: JPA# APPLICANTS Part 1 = General Information PLEASE PRINT OR TYPE ALL ANSWERS: Ifa question does not apply to your project, please print N/A (not applicable) in the space provided. Ifadditional space is needed, attach 8-1/2x 11 inch sheets of paper. Check all that apply Pre-Construction Notification (PCN) Regional Permit 17 (RP-170 Rang NWP# Carbarlinkyue 5568 Vorkhaven Lane (For Nationwide Permits ONLY- No DEQ- VWP permif writer will be assigned) Gloycesker Vk County or City in which the project is located: Gloueesker,A Waterway at project site: yovi< RIver PREYIOUSACTIONS RELATED TO THE PROPOSED WORK (Include dlIfederal, state, and local pre application coordination, site visits, previous permits, or applications whether issued, withdrawn, ar denied) Historical information for past permit submittals can be found online with VMRC htips/Awebappsr mrcv virginia povipublichabital or VIMS mAENmSasEN htm! Agency Action / Activity Permil/Project number, including any Date of Ifdenied, give reason non- -reporting Nationwide permits Action for denial previously used (e. B. NWP 13) Application Revised. October 2019 Part 1- General Information (continued) 1. Applicant's S legal name* and complete mailing address: Contact Information: Home Rana Graham - Montaque Work 2024 Hor nes Lake Road Fax 2318s Cell (80y) 640 8545 wiliamsbtgvA e-mail rdarahan23 mne. Cem State Corporation Commission Name and ID Number (ifa applicabley 2. Property owner(s) legal name and complete address, ifdifferent from applicant: Contact Information: Rana Graham- Montaque Home 5568 Haven Lane Work York Fax Glouce stcry VA 53061 Cell (804) 640 8545 c-mail rdgr re ham 230 mc.Com State Corporation Commission Name and ID Number (ifapplicable) 3. Authorized agent name* and complete mailing Contact Information: address (ifapplicable): Home Work Fax Cell e-mail State Corporation Commission Name and ID Number (ifapplicable), * If multiple applicants. property owners, and/or agents. cach must bel listed and each must sign the applicant signature page. 4. Provide a detailcd description ofthe project in the space below, including the type of project, its dimensions, materials, and method of construction. Be sure to include how the construction site will be accessed and whether tree clearing and/or grading will be required, including the total acreage. If the project requires pilings, please be sure to include the total number, type (e.g. wood, steel, etc), diameter, and method ofi installation (c.g. hammer, vibratory.jetted, etc). Ifadditional space is needed, provide a separate sheet of paper with the project description. lpsiallalion o 100 ligear, fct of revetment ,n fontof, an RyiSt74 boulkhead. S41+ E wooc vol be gucicd on the ousdc of bukat 45 Needed." Tne burishes will be lescied signtiy to be PAPPPT h.nd e noyh. So, to flvoids. Class A - I riprap on cedi-pene ontne 4Me uall will De insigled firer gotn wdl le 2401 onthg Tne "SAMAr witha 51°pe faca and avound 4 felt wide Giadediflicd 4-4.5 Pcr tau b, jopsor) lwn afegs wil usns Smbts muicv). Oadeifid saire oiner distutbed lawn Seed, shiaw Will DR repaed. xL Wat and a 18'38' $, *owith a 20'y Toconstruct spler boqt lif+ and to install an estimaled boathowse for (TeD)lb installeg 46 tberplesivaak! ND 12"davekr Octaber 2019 gpelorthan Application Revised. 1 n 9 vibrgtory manney Part 1 - General Information (continued) 1. Applicant's legal name* and complete mailing address: Contact Information: Home Rana Graham = Montaque Work 2024 Hor pes Lake Road Fax wiiamsbtgvA 23185 Cell (80y)640 8545 e-mail ndarabam236 Mne. Cor State Corporation Commission Name and ID Number (if applicabley 2. Property owner(s) legal name* and complete address, ifdifferent from applicant: Contact Information: Rana M ontaque Home ( Graham Work 5568 Vork_Haven Lane Fax - Glouce Stcr, VA 53061 Cell (304) 640 8545 c-mail rds ra ham 230 mc.com State Corporation Commission Name and ID Number (if: applicable) 3. Authorized agent name" and complete mailing Contact Information: address (if: applicable): Home Work Fax Cell e-mail State Corporation Commission Name and ID Number (if applicable) AI multiple applicants. property owners, and/ lor agents, cach must be listed and cach must sign the applicant sipnature page. 4. Provide a detailed description ofthe project in the space below, including the type ofp project, its dimensions, materials, and method of construction. Be sure to include how the construction site will be accessed and whether tree clearing and/or grading will be required, including the total acreage. If the project requires pilings. please be sure to include the total number, type (e.g. wood, steel, etc), diameter, and method of installation (e. g. hammer, vibratory, jetted, etc). If additional space is needed, provide a separate sheet ofpaper with the project description. lpsiallation 0-( ( 00 Ivcar fct ef revetment iV fo ef an RxiS1T1 bulkbead, SAH voil R dacicd - oi the uside of bukncat 15 The be te wal pe lorinl slgntiy epupad ppargp behin buusnci 503 to Class A - I € flvoids Acceso eai-jencle riprap on ontne VNe uall wiD De insiled gotn topf 7A Tnc revcmeny wal be witha 2ol siops onthg faca hu ind KvouAd 4 felt wide Gidediflic 54,5 Lxwn areep WILI bo wsns topsei) yuicy. Ovadeifiikd Srad otner dishicbed lavn RE Seed,shaws wIL pR repared. Wwad anda a18'38' a 20'xmu To construct S'6'with boat Ki64 and to install an estimaed boathowse 2E installed 4b ND 12"dawekr October gpekorthan Application Revised. krc.nesiveak 1n q vibratory manney Part 1 - General Information (continued) 5. Have you obtained a contractor for the project? X Yes* No. *Ifyour answer is "Yes" complete the remainder of this question and submit the Applicant's 's and Contractor's Acknowledgment Form (enclosed) Contractor'sname" and complete mailing address: Contact Information: Home RLWMArne Copsirwefion Work PD Box Fax Cell (844) 725 151 Cobbs Cyaek,v- 23055 email rwn marine consHudioneeg mail-con State Corporation Commission Name and ID Number (ifa applicable) * If multiple contractors, each must be listed and cach must sign the applicant signature page. 6. List the name, address and telephone number ofthe newspaper having general circulation in the area ofthe project. Failure to complete this question may delay local and State processing. Name and complete mailing address: Telephone number Glou asley Mathews Gazcte (804)6 693-3 3101 PD Box 2060 Gloud ceskcr) VA 230b1 7. Give the following project location information: Street Address (911 address ifavailable) 556 8 YorK Haven Lgne Lot/Block/Parcel#, 21914 Subdivision City / County dioycester ZIP Code 23068- Latitude and Longitude at Center Point of Project Site (Decimal Degrees): 37.369 35N / 76. 62533'w (Example: 36.416001-7630733) Ifthe project is located in a rural area, please provide driving directions giving distances from the best and nearest visible landmarks or major intersections. Note: ifthe project is in an undeveloped subdivision or property, clearly stake and identif property lines and location of the proposed project. As supplemental mapshowing how the property is to be subdivided should also be provided. sec at-achment1 8. What are the primary and. secondary purposes of and the need for the project? For example, the primary purpose may be "to protect property from erosion due to boat wakes"a and the secondary purpose may be "to provide safer access to a pier." 1 Prokct +he crpert Y from crroston and Shorelne woith +he bwnead compromise ovisivg-faling Secondary pur pose is +to 5 afely gan access to augable waler Application Revised: October 2019 Part 1 - General Information (continued) 9. Proposed use (check one): X < Single user (private, non-commercial, residential) Multi-user (community, commercial, industrial, government) 10. Describe alternatives considered and the measures that will be taken to avoid and minimize impacts, to the maximum extent practicable, to wetlands, surface waters, submerged lands, and buffer areas associated with any disturbance (clearing, grading, excavating) during and after project construction. Please be advised that unavoidable losses of tidal wetlands andlor aquatic resources may require compensatory mitigation. No viable Ql-cynatves 11. Is this application being submitted for after-the-fact authorization for work which has already begun or been completed? X Yes No. Ifyes, be sure to clearly depict the portions ofthe project which are already complete in the project drawings. Please See attachment2 12. Approximate cost ofthe entire project (materials, labor, etc.):S 80,000 Approximate cost ofthat portion ofthe project that is channelward of mean low water: $ 13. Completion date ofthe proposed work: 8125 14. Adjacent Property Owner Information: List the name and complete mailing address, including zip code, of cach adjacent property owner to the project. (NOTE: ifyou own the adjacent lot, provide the requested information for the first adjacent parcel beyond your property line. ) Failure to provide this information may result in a delay in the processing of your application by VMRC. Christopher Radey 55 80 York Haven Lane Gioucester, Virginia 23061 Frances WRaver 5560 yrk Hawen LAne Gloucestcr 23061 Virginia Application Reviscd: October 2019 Attachment 1. 5568 York Haven Lane Gloucester, VA Left on hickory fork road Left on Cappahosic road Left on York haven lane 5568 York haven lane 2D 100 m Attachment 2 Contractor Jonathan Kannady (804) 699-0191 began project unbeknownst to me without a permit or an active license. The agreement was that he was to pull the permit even though - - inquired with the county about the process. His quote of 80k which was substantially more than my quoted in Lancaster determined that he was going to do the permit work. Sand fill has been placed in the eroded shoreline with treated wood repairs to the existing bulkhead including one load of quarry rocks all inspected by the county. Part 2 - Signatures 1. Applicants and property owners (if different from applicant). NOTE: REQUIRED FOR ALL PROJECTS RMACYACISTATANENE The Department of the Army permit program is authorized by Section 10 of the Rivers and Harbors Act of 1899, Section 404 of the Clean Water Act, and Section 103 of the Marine Protection Research and Sanctuaries Act of 1972. These laws require that individuals obtain permits that authorize structures and work in or affecting navigable waters of the United States, the discharge of dredged or fill material into waters of the United States, and the transportation of dredged material for the purpose of dumping it into ocean waters prior to undertaking the activity. Information provided in the Joint Permit Application will be used in the permit review process and is a matter of public record once the application is filed. Disclosure of the requested information is voluntary, but it may not be possible to evaluate the permit application or to issue a permit if the information requested is not provided. CERTIFICATION: I am hereby applying for all permits typically issued by the DEQ. VMRC, USACE, and/or Local Wetlands Boards for the activities I have described herein. I agree to allow the duly authorized representatives of any regulatory or advisory agency to enter upon the premises of the project site at reasonable times to inspect and photograph site conditions, both in reviewing a proposal to issue a permit and after permit issuance to determine compliance with the permit. In addition, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather. and evaluate the information submitted. Based on my inquiry ofthe person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. Iam: aware that there are significant penalties for submitting falseinformation. including the possibility of fine and imprisonment for knowing violations. Ranc Gvaham Mantague Applicant's Legal Name (printed/typed) (Use ifr more than one applicant) a A C - - - - - Applicant s Signature (Use if more than one applicant) 26195 Date Rana Gnham- Monlague Property Owner's Legal Name (printedtyped (Use ifmore than one owner) (Ifdifferent fromp Applicant) A2L Property Owner's 's Signature (Use if more than one owner) 26h5 Date Application Revised: October 2019 APPENDIX B M U.S. Army Corps Of Engineers REGIONAL PERMIT 17 CHECKLIST Norfolk District Expires September 5, 2023 Please review the 18-RP-17 enclosure before completing this form and note 18-RP-17 can only be used for proposed PRIVATE USEstructure(s) that comply with the terms and conditions of 18-RP-17. Copies can be obtained online at http:lwww.nao.usaceammymiMisslons/Regulatony/RBregional. YESDNOD (1) Has the permittee reviewed the 18-RP-17 enclosure and verified that the proposed structure(s) is in compliance with all the terms, conditions, and limitations of 18-RP-17? YESDNOD (2) Does the proposed structure(s) extend no more than one-fourth of the distance across the waterway measured from either mean high water (MHW) to MHW (including all channelward wetlands) or ordinary high water (OHW) to OHW (including all channelward wetlands)? VESEINOD (3) Does the proposed structure(s) extend no more than 300 feet from MHW or OHW (including all channelward wetlands)? VESENODNAE (4) Does the proposed structure(s) attach to the upland at a point landward of MHW or OHW (including all channelward wetlands)? YESDNODIN NIAL (5) If the proposed structure(s) crosses wetland vegetation, is it an open-pile design that has a maximum width of five (5) feet and a minimum height of four (4) feet between the decking and the wetland substrate? YESNONAD (6) Does the proposed structure(s) include no more than two (2) boatlifts and no more than two (2) boat slips? YESDNODNAD (7) Is the open-sided roof structure designed to shelter a boat $ 700 square feet and/or is the open sided roof structure or gazebo structure designed to shelter a pier $ 400 square feet? YESNODNAD (8). Are all piles associated with the proposed structure(s) non-steel, less than or equal to 12" in diameter, and will less than or equal to 25 piles be installed channelward of MHW? YESDNODNAD (9) Is all work occurring behind cofferdams, turbidity curtains, or other methods to control turbidity being utilized when operationally feasible and federally listed threatened or endangered species may be present? YESDNOD NIAD (10) If the proposed structure(s) is to be located within an anadromous fish use area, the prospective permittee will adhere to the anadromous fish use area time of year restriction (TOYR) prohibiting in-water work from occurring between February 15 through June 30 of any given year if(1) piles are to be installed with a cushioned impact hammer and there is less than 492 feet between the most channelward pile and mean low water (MLW) on the opposite shoreline or (2) piles are to be installed with a vibratory hammer and there is less than 384 feet between the most channelward pile and MLW on the opposite shoreline. YESONOD (11) Is all work occurring outside of submerged aquatic vegetation (SAV) mapped by the Virginia Institute of Marine Sciences' (VIMS) most recent survey year and 5 year composite? YESENOD (12) Has the permittee ensured the construction and/or installation of the proposed structure(s) will not affect federally listed threatened or endangered species or designated critical habitat? YESNOD (13) Wil the proposed structure be located outside of Broad Creek in Middlesex County, Fisherman's Cove in Norfolk, or the Salt Ponds in Hampton? VES NODJ (14) Will the proposed structure(s) be located outside of the waterways containing a Federal Navigation Project listed in Permit Specific Condition 12 of 18-RP-17 and/or will all portions of the proposed structure(s) be located more than 85 feet from the Federal Navigation Project? Application Revised: October 2019 13 YESEINOD (15) Will the proposed structure(s) be located outside a USACE Navigation and Flood Risk Management project area? YESDNOD (16) Will the proposed structure(s) be located outside of any Designated Troul Waters? YESD3 NOD N/AD (17) If the proposed structure(s) includes flolation units, wil the units be made of materials that will not become waterlogged or sink if punctured? YESEINODNAD (18) I the proposed structure(s) includes flotation units, will the lloating sections be braced so they will not rest on the bottom during periods of low water? YESENOD (19) Is the proposed structure(s) made of suitable materials and practical design so as to reasonably ensure a safe and sound structure? YESENOD (20) Will the proposed structure(s) be located on the property in accordance with the local zoning requirements? VESNODNAD (21) I the proposed structure(s) includes a device used for shellfish gardening. will the device be attached directly to a pier and limited to a total of 160 square feet? YESD NODJ NIAD (22) If the proposed structure(s) includes a device used for shellfish gardening, does the permittee recognize this RP does not negate their responsibility to obtain an oyster gardening permit (General Permit #3) from Virginia Marina Resources Commission's Habitat Management Division? YES3NOD (23) Does the permittee recognize this RP does not authorize any dredging or filing of waters of the United States (including wellands) and does not imply that future dredging proposals will be approved by the Corps? YESDINOD (24) Does the permittee understand that by accepting 18-RP-17, the permittee accepts all of the terms and conditions of the permit, including the limits of Federal liability contained in the 18-RP- 17 enclosure? Does the permittee acknowledge that the structures permitted under 18-RP-17 may be exposed to waves caused by passing vessels and that the permittee is solely responsible for the integrity of the structures permitted under 18-RP-17 and the exposure of such structures and vessels moored to such structures to damage from waves? Does the permittee accept that the United States is not liable in any way for such damage and that it shall not seek to involve the United States in any actions or claims regarding such damage? IF YOU HAVE ANSWERED "NO" TO ANY OF THE QUESTIONS ABOVE, REGIONAL PERMIT 17 (18-RP-17) DOES NOT APPLY AND YOU ARE REQUIRED TO OBTAIN WRITTEN AUTHORIZATION FROM THE CORPS PRIOR TO PERFORMING THE WORK. IF YOU HAVE ANSWERED "YES" (OR "N/IA", WHERE APPLICABLE) TO ALL OF THE QUESTIONS ABOVE, YOU ARE IN COMPLIANCE WITH REGIONAL PERMIT 17 (18-RP-17). PLEASE SIGN BELOW, ATTACH, AND SUBMIT THIS CHECKLIST WITH YOUR COMPLETED JOINT PERMIT APPLICATION (JPA). THIS SIGNED CERTIFICATE SERVES AS YOUR LETTER OF AUTHORIZATION FROM THE CORPS. YOU WILL NOT RECEIVE ANY OTHER WRITTEN AUTHORIZATION FROM THE CORPS; HOWEVER, YOU MAY NOT PROCEED WITH CONSTRUCTION UNTIL YOU HAVE OBTAINED ALL OTHER NECESSARY STATE AND LOCAL PERMITS. I CERTIFY THAT I HAVE READ AND UNDERSTAND ALL CONDITIONS OF THE REGIONAL PERMIT 17 (18-RP-17), DATED SEPTEMBER 2018, ISSUED BY THE US ARMY CORPS OF ENGINEERS, NORFOLK DISTRICT REGULATORY BRANCH (CENAO-WRR), NORFOLK, VIRGINIA. Proposed work to be located at: RAL 5508 YorE haveA lane Signature of Property Owner(s) or Agent Gnxs SHCAA 261 VMRC Number: Date 82.2115 Application Revised October 2019 14 Part3 - Appendices Please complete and submit the appendix questions applicable to your project, and attach the required vicinity map(s) and drawings to your application. If an item does not apply to your project, please write "N/A"in the space provided. Appendix A: (TWO PAGES) Projects for Access to the water such as private and community piers, boathouses, marinas, moorings, and boat ramps. Answer all questions that apply. 1 Briefly describe your proposed project. installation of 100 knear fcet nprap fevehment - oy CASHM9 bwlKheed Construct NEW picr wihh a boathowse and H for privak residance usc 2. For private, noncommercial piers: Do you have an existing pier on your property? Yes X No If yes, will it be removed? Yes No Is your lot platted to the mean low water shoreline? Xyes No What is the overall length of the proposed structure? 12.0 feet. Channelward of! Mean High Water? 11O feet. Channelward of Mean Low Water? 96 feet. What is the area ofthe piers and platforms that will be constructed over Tidal non-vegetated wetlands I6 00 square feet. Tidal vegetated wetlands square feet. Submerged lands 1000 square feet. What is the total size of any and all L- or T-head platforms? 400sq. ft. For boathouses, what is the overall size ofthe roof structure? 048 sq. ft. Will your boathouse have sides? Yes X No. NOTE: All proposals for piers, boathouses and shelter roofs must be reviewed by the Virginia Marine Resources Commission (Commission or VMRC), however, pursuant to $ 28.2-1203 A 5 of the Code ofVirginia a VMRC permit may not be required for such structures (except as required by subsection Dof $ 28.2-1205 for piers greater than 100 feet in length involving commercially productive leased oyster or clam grounds). provided that (1) the piers do not extend beyond the navigation line or private pier lines established by the Commission or the United States Army Corps of Engincers (USACE), (11) the piers do not exceed six feet in width and finger piers do not exceed five fect in width, (in) any L or T head platforms and appurtenant floating docking platforms do not exceed, in the aggregate, 400 square feet, (iv) if prohibited by local ordinance open-sided shelter roofs or gazebo-type structures shall not be placed on platforms as described in clause (in), but may be placed on such platforms if not prohibited by local ordinance, and (v) the piers are determined not to be a navigational hazard by the Commission. Subject to any applicable local ordinances, such piers may include an attached boat lift and an open-sided roof designed to shelter a single boat slip or boat lift. In cases in which open-sided roofs designed to shelter a single boat, boat slip or boat lift will exceed 700 square feet in coverage or the open-sided shelter roofs or gazebo structures exceed 400 square feet, and in cases in which an adjoining property owner objects to a proposed roof structure, permits shall be required as provided in $ 28.2-1204. Application Revised: October 2019 15 Part3- Appendices (continued) 3. For USACE permits, in cases where the proposed pier will encroach beyond one fourth the waterway width (as determined by measuring mean high water to mean high water or ordinary high water mark to ordinary high water mark), the following information must be included before the application will be considered complete. For an application to be considered complete: a. The USACE MAY require depth soundings across the waterway at increments designated by the USACE project manager. Typically 10-foot increments for waterways less than 200 feet wide and 20- foot increments for waterways greater than 200 feet wide with the date and time the measurements were taken and how they were taken (e.g g, tape, range finder, etc.) ). b. The applicant MUST provide a justification as to purpose ift the proposed work would extend a pier greater than one-fourth oft the distance across the open water measured from mean high water or the channelward edge ofthe wetlands. C. The applicant MUST provide justification ifthe proposed work would involve the construction of a pier greater than five feet wide or less than four feet above any wetland substrate. 4. Provide the type, size, and registration number of the vessel(s) to be moored at the pier or mooring buoy. Type Length Width Draft Registration # TBD For Marinas, Commercial Piers, Governmental Piers, Community Piers and other non-private piers, provide the following information: A) Have you obtained approval for sanitary facilities from the Virginia Department of Health? (required pursuant to Section 28.2-1205 Cof the Code of Virginia). B) Will petroleum products or other hazardous materials be stored or handled at your facility? C) Will the facility be equipped to off-load sewage from boats? D) How many wet slips are proposed? How many are existing? E) What is the area of the piers and platforms that will be constructed over Tidal non-vegetated wetlands square feet Tidal vegetated wetlands square feet Submerged lands square feet For boat ramps, what is the overall length ofthe structure? feet. From Mean High Water? feet. From Mean Low Water? feet. Note: drawings must include the construction materials, method of installation, and all dimensions. If tending piers are proposed, complete the pier portion. Note: Ifdredging or excavation is required, you must complete the Standard Joint Point Permit application. Application Revised: October 2019 16 EaTy vAe Part 3 = Appendices (continued) Appendix B: Projects for Shoreline Stabilization in tidal wetlands, tidal waters and dunes/beaches including riprap revetments and associated backfill, marsh toc stabilization, bulkheads and associated backfnll, breakwaters, beach nourishment, groins, jctties, and living shoreline projects. Answer all questions that apply. Please provide any reports provided from the Shoreline Erosion Advisory Service or VIMS. NOTE: It is the policy of the Commonwcalth that living shorelines are the preferred altemative for stabilizing tidal shorelines (Va. Code $ 28.2-104.1). Information on non-structural, vegetative alternatives (i.e., Living Shoreline) for shoreline stabilization is available at AEPEMmadN zone/living shoreinss/nde.htm, 1. Describe each revetment, bulkhead, marsh toe, breakwater, groin, jetty, other structure, or living shoreline project separately in the space below. Include the overall length in linear feet, the amount of impacts in acres, and volume ofassociated backfill below mean high water and/or ordinary high water in cubic yards, as applicable: rev cment,salt / treakd install 100 lincal fcsl of rip rap Plymarlrepair -o fauliny bulkhead. Class *-i riprap installed on filtcr cloth on top of wali with A 2 +e 1 Slope fac. Revethw will DC 4-4.5 feek tall ay4 9pet widc. Grated +Alled undirsturked (awn area repaures wlth tepsolysedifhaw Mulch 46 estimaked tmper plles trealed NO ograkr than IR"aiamek ihstall-td In a vibratory Ma nner, vew picy S'isa' with G 20%)6 Lheod chd 18v38 bost house open fora lojopo Ib jpoat (et 2. What is the maximum encroachment channelward ofmean high water? uD feet. Channelward of mean low water? 9b_feet. Channelward of the back edge of the dune or beach? feet. 3. Please calculate the square footage of encroachment over: Vegetated wetlands 100 square feet Non-vegetated wetlands ) square feet Subaqueous bottom square feet Dune and/or beach square feet 4. For bulkheads, is any part of the project maintenance or replacement of a previously authorized, currently serviceable, existing structure? X Yes No. If yes, will the construction of the new bulkhead be no further than (wo (2) feet channelward ofthe existing bulkhead? X Yes No. Ifno, please provide an explanation for the purpose and need for the additional encroachment. Application Revised: Oclober 2019 17 Part 3 - Appendices (continued) 5. Describe the type of construction and all materials to be used, including source of backfill material, if applicable (e.g., vinyl shect-pilc bulkhead, timber stringers and butt piles, 100% sand backfill from upland source; broken concrete core material with Class II quarry stone armor over filter cloth). NOTE: Drawings must include construction details, including dimensions, design and all materials, including fittings if used. ClassI and I uaryy Stone J Filer Cloth, Sift fence +reated lumber, hdg hardware 1 Sandl 6. Ifusing stone, broken concrete, etc. for your structure(s), what is the average weight of the: Core (inner layer) material 75 pounds per stone Class size Armor (outer layer) material 250 pounds per stone Class size II For beach nourishment, including that associated with breakwaters, groins or other structures, provide the following: Volume of material cubic yards channelward of mean low water cubic yards landward of mean low water cubic yards channelward of mean high water cubic yards landward of mean high water Area to be covered square feet channelward ofmean low water square feet landward of mean low water cubic yards channelward of mean high water cubic yards landward of mean high water Source of material, composition (e.g. 90% sand, 10% clay): Method of transportation and placement: Byland Describe any proposed vegctative stabilization mcasures to be used, including planting schedule, spacing, monitoring, etc. Additional guidance is available at htp./wnnwaimsslwabousanchinamolentingiguideine: Applic alion Rcviscd: October 2019 18 Part3-Appendices (continued) Appendix C: Crossings in, on, over, or under, waters, submerged lands, tidal wetlands and/or dunes and béachgs, including but not limited to, bridges, walkways, pipelines and utility lines. 1. What is the purpose and method ofinstallation of the crossing? 2. What is the width oft the waterway and/or wetlands to be crossed from mean high water to mean high water (tidal waters)? feet. from mean low water to mean low water (tidal waters)? feet. from ordinary high water to ordinary high water (non-tidal waters)? feet. 3. For bridges (footbridges, golf cart bridges, roadway bridges, etc.), what is the width ofthe structure over the tidal wetlands, dunes/ beaches and/ Vor submerged lands? square feet. 4. For overhead crossings: a. What will be the height above mean high water? feet. b. Ifthere are other overhead crossings in the area, what is the minimum height? feet. C. Ifthe proposed crossing is an electrical line, please confirm the total number of electrical circuits: 5. For buried crossings, what will be the depth below the substrate? feet. Will the proposed utility provide empty conduits for any additional utilities that may propose to co-locate at a later date? Yes No. 6. Will there be any excavation or fill required for placement of abutments, piers, towers, or other permanent structures on State-owned submerged lands, tidal wetlands, and dunes/ beaches? Yes X No. Ify yes, please provide the following: a. Amount ofexcavation in wetlands cubic yards square feet b. Amount of excavation in submerged land cubic yards square feet C. Amount of excavation in dune/beach cubic yards square feet d. Amount of fill in wetlands cubic yards square feet e. Amount of fill in submerged lands cubic yards square feet f. Amount of fill in dune/beach cubic yards square feet Application Revised October 2019 19 Part 3 - Appendices (continued) Appendix D: Aquaculture Related Structures such as cages and floats. Before completing this appendix, please review the aquaculture requirements summary at: http/mre virginia. goy Shellfish Aquaculture.shtm. 1. Will the activity be for commercial purposes? Yes - No. IfYes and structures will be placed upon an oyster ground lease, you may qualify for the VMRC General Permit #4 for Temporary Protective Enclosures for Shellfish. For more info see: http:www.mres virginia. goviregulations/MRC Scanned Regs/Shellfish Mix/ /fr1130 12-0107.pdf. If you qualify for the General Permit #4, or if such structures are proposed that are not on an oyster planting ground lease, or for floating structures of any kind, complete this Joint Permit Application and include the necessary information requested below in question 2 through 11. IFNo, you may qualify for the VMRC General Permit #3, for Noncommercial Riparian Shellfish Growing (i.e. "Gardening") For more information sec: htp/www.mre: vinythniagovfommsyGP Aquaculture. doc.pdf. If you qualify for this gencral permit use the Abbreviated Joint Permit Application For Noncommercial Riparian Shellfish Aquaculture Structures available at https:/mre. ishiam.OPVGP Aquaculture form 2019.pdr do not use this Joint Permit-Application. 2. Will aquaculture structures be attached to an existing pier or other structure? Yes X No. 3. The plat file # if proposed upon oyster planting ground lease(s). 4. The maximum area where enclosures are proposed. square feet 5. The maximum number of enclosures being proposed to be deployed. 6. The species of shellfish to be cultured. 7. A detailed description ofthe enclosures to include width, length and height. 8. In addition to the requirements itemized in Part 4 Project Drawings, the following additional information must be included on your project drawings: A general description of the area within 500 feet of deployment area. Provide a drawing that depicts existing marine resources such as SAV, shellfish beds, fixed fishing devices, public grounds, piers, water depths at mean low water, tide range, and the minimum clearance at mean low tide over the enclosures. 9. Provide the date enclosures are proposed to be deployed How will the structures be secured? Application Revised October 2019 20 Part 4 - Project Drawings Plan view and cross-sectional view drawings are required for all projects. Application drawings do not need to be prepared by a professional draftsman, but they must be clear, accurate, and should be to an appropriate scale. Ifa scale is nol used, all dimensions must be clearly depicted in the drawings. If available, a plat oft the property should be included, with the existing and proposed structures clearly indicated. Distances from the proposed structure(s) to fixed points of reference (benchmarks) and to the adjacent property lines must be shown. A vicinity map (County road map, USGS Topographic map, etc. ) must also be provided to show the location ofthe property. NOTE: The sample drawings have been included at the end ofthis section to provide guidance on the information required for difterent types of projects. Clear and accurate drawings are essential for project review and compliance determination. Incomplete or unclear drawings may cause delays in the processing of your application. The following items must be included on ALL project drawings: (plan and cross-sectional, as appropriate) name of project north arrow scale - waterway name - existing and proposed structures, labeled as such dimensions of proposed structures mean high water and mean low water lines :. all delineated wetlands and all surface waters on the site, including the Cowardin classification (i.e., emergent, scrub-shrub, or forested) for those surface waters (if applicable) limits of proposed impacts to surface waters, such as fill areas, riprap scour protection placement, and dredged areas, and the amount of such impacts in square feet and acres ebb/flood direction adjacent property lines and owner's name distances from proposed structures to fixed points of reference (benchmarks) and adjacent property lines Application Revised: Oclober 2019 22 Part3-Appendices (continued) 10. List of all riparian land owners within 500 feet ofthe area where enclosures are proposed along with a map (tax map or other suitable map) depicting the locations ofsuch parcels or riparian property owner acknowledgement forms signed by the riparian land owner with any comments concerning the enclosures deployment request. 11. Proof that the applicant holds a current oyster or clam aquaculture product owners permit, and verification that the applicant is in compliance with Mandatory Harvest Reporting requirements, and verification that the current years oyster ground rent is paid, ifstructures are proposed on an oyster ground lease. Application Reviscd: October 2019 21 TYPICAL SECTION RIPRAP REVETMENT Seed/straw denude & aregs SF & à 1 face gishins Slope bul Khed +6.0' W Hhrepurs Filter Cloth Riprap Filter Cloth 18" Toe 2' MAX Rana Riprap Project for: 5568 Vovk hqven Gigperigs Glowceser,A Date: 2./2412.5 Sheet 1 of 3 DRAWING NOT TO SCALE 50 Boatlfb 3MHW 2.5MWW sSM bSir 8' OC 8'OC 2"x8" 6" above decking & - - Decking 2"x g Stringers 2"xs'Sills Bolted 1/2" Galvanized Boits s" Piles 8"I0"CCA treatcd drven R'-ID Into Shps per substvatc Conditions a"x 8"roagh curf crossties Sectional View - Typical Pier Construction Stnagers.yeigis Note: Pierhead will be of similar construction. 2gil4raddedin, Stainkss Screws, noi dppel 341vanzd Vardware + nals Rana Graham-Montagu Pier Project for: 5S6Fyock haven Lane Giewcesicrww Date: 2124l25 Sheet 1 of 3 Drawing not to scale 61 36' lo' LIPT +b.o' NHw/2.5 MLW lo.05 Botro M zo' Ao 5 07 ibol - 15' -25' -30' -351 4.o! 6PEN-SIDED 38' POOF = 5' VB' x3b' =. 648 SF 18' LFT - 3' 33' 8 160 L o' 1o' zo' 20' 20 SEA1E-1' zo 20' 150 TOTAL -llo' Tio MEW 5 9b' To MLW Rana Gvaham - Montaque 7pey Pig.ct Hovenlanc 556 8 yovk Glouce Stry Vik 2/24125 3of3 Part 5 - Chesapeake Bay Preservation Act Information All proposed development, redevelopment, land disturbance, clearing or grading related to this Tidewater JPA must comply with the Chesapeake Bay Preservation Area Designation and Management Regulations, which are enforced through locally adopted Chesapeake Bay Preservation Area (CBPA) ordinances. Compliance with state and local CBPA requirements mandates the submission of: a Water Quality Impact/Aissessment (WQIA) for the review and approval of the local government. Contact the appropriate local government office to determine if a WQIA is required for the proposed activity(ies). Because the 84 local governments within Tidewater Virginia are responsible for enforcing the CBPA Regulations, (he completion of the JPA process does not constitute compliance with the Bay Act Regulations nor does it guarantee that the local government will approve encroachments into the RPA that may result from this project. Applicants should contact their local govemment as carly in the design process as possible to ensure that the final design and construction of the proposed project meets all applicable CBPA requirements. Early cooperation with local government staff can help applicants avoid unnecessary and costly delays to construction. Applicants should provide local government staff with information regarding existing vegetation within the Resource Protection Area (RPA) as well as a description and site drawings ofany proposed land disturbance, construction, or vegetation clearing. As part of their review and approval processes, local govemment staff will evaluate the proposed project and determine whether or not approval can be granted. Once the locality has made a decision on the project, they will advise the Local Wetlands Boards and other appropriate parties of applicable CBPA concerns or issues. Resource Protection Areas (RPAs) are composed of the following features: 1. Tidal wetlands; 2. Nontidal wetlands connected by surface flow and contiguous to tidal wetlands or water bodies with perennial flow; 3. Tidal shores; 4. Other lands considered by the local government to meet the provisions of subsection A of 9VAC25-830-80 and to be necessary to protect the quality of state waters; and 5. A buffer area not less than 100 fect in width located adjacent to and landward of the components listed in subdivisions 1 through 4 above, and along both sides of any water body with perennial flow. Notes for all projects in RPAS Development, redevelopment, construction, land disturbance, or placement of fill within the RPA features listed above requires the approval of the locality and may require an exception or vanance from the local Bay Act ordinance. Please contact the appropriate local government to determine the types of development or land uses that are permitted within RPAS. Pursuant 1O 9VAC25-830-110, on-site delincation of the RPA is required for all projects in CBPAS. Because USGS maps are not always indicative of actual "in-field" conditions, they may not be used to determine the site-specific boundaries of the RPA. Notes for shoreline erosion control projects in RPAS Re-establishment of woody vegetation in the buffer will be required by the locality to mitigate for the removal or disturbance of buffer vegetation associated with your proposed project. Please contact the local govemment to determine the mitigation requirements for impacts to the 100-foot RPA buffer. Application Reviscd October 2019 23 Part 5 - Chesapeake Bay Preservation Act Information (continued) Pursuant to 9VAC25-830-140 5 a (4) of the Virginia Administrative Code, shoreline crosion projects are a permitted modification to RPAs provided that the project is based on the "best technical advice" and complies with applicable permit conditions. In accordance with 9VAC25-830-140 I ofthe Virginia Administrative Code, the locality will use the information provided in this Part V, in the projeci drawings, in this permit application, and as required by the locality, to make a determination that: 1. Any proposed shoreline erosion control mcasure is necessary and consistent with the nature ofthe erosion occurring on the site, and the measures have employed the "best available technical advice" 2. Indigenous vegetation will be preserved to the maximum extent practicable 3. Proposed land disturbance has been minimized 4. Appropriate mitigation plantings will provide the required water quality functions of the buffer (9VAC25-830-140 3) 5. The project is consistent with the locality's comprchensive plan 6. Access to the project will be provided with the minimum disturbance necessary. Application Revised: Octaber 2019 24