Fillable JOINT APPLICATION FOR PROPOSED WORK IN MONTANAS STREAMS, (Cascade County)

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JOINT APPLICATION FOR PROPOSED WORK IN MONTANAS STREAMS, (Cascade County)

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JOINT APPLICATION FOR PROPOSED WORK IN MONTANA’S STREAMS, WETLANDS, FLOODPLAINS,
AND OTHER WATER BODIES
Use this form to apply for one or all local, state, or federal permits listed below. The applicant is the responsible party for the project and the
point of contact unless otherwise designated. “Information for Applicant” includes agency contacts and instructions for completing this
application. To avoid delays, submit all required information, including a project site map and drawings. Incomplete applications will result in
the delay of the application process. Other laws may apply.
The applicant is responsible for obtaining all necessary permits and landowner permission before beginning work.
PERMIT
AGENCY
FEE
310 Permit
Local Conservation District
No fee
SPA 124 Permit
Department of Fish, Wildlife and Parks
No fee
Floodplain Permit
Local Floodplain Administrator
Varies by city/county
($25 - $500+)
Section 404 Permit, Section 10 Permit
U. S. Army Corps of Engineers
Varies ($0 - $100)
318 Authorization
401 Certification
Department of Environmental Quality
$250 (318);
$400 - $20,000 (401)
Navigable Rivers Land Use License, Lease, or
Easement
Department of Natural Resources and
Conservation, Trust Lands Management Division
$50, plus additional fee
A. APPLICANT INFORMATION
NAME OF APPLICANT (person responsible for project):_________________________________________________
Has the landowner consented to this project? □ Yes □ No
Mailing Address: __________________________________________________________________________
Physical Address: __________________________________________________________________________
Day Phone: ______________Evening Phone: ______________ E-Mail: ______________________________
NAME OF LANDOWNER (if different from applicant):______________________________________________
Mailing Address: __________________________________________________________________________
Physical Address: __________________________________________________________________________
Day Phone: ______________Evening Phone: ______________ E-Mail: ______________________________
NAME OF CONTRACTOR/AGENT (if one is used):________________________________________________
Mailing Address: __________________________________________________________________________
Physical Address: __________________________________________________________________________
Day Phone: ______________Evening Phone: ______________ E-Mail: ______________________________
B. PROJECT SITE INFORMATION
NAME OF STREAM or WATER BODY at project location _____________ Nearest Town ______________
Address/Location:_______________________________Geocode (if available): __________________________
____1/4 ____1/4 ____1/4, Section ________, Township _________, Range _________ County ____________
Longitude _____________________, Latitude ________________________________
The state owns the beds of certain state navigable waterways. Is this a state navigable waterway? Yes or No.
If yes, send copy of this application to appropriate DNRC land office – see Information for Applicant.
AGENCY USE ONLY: Application # ___________ Date Received ____________
Date Accepted ____________/ Initials _____ Date Forwarded to DFWP ____________
Revised: 6/5/15 (310 form 270). Form may
be downloaded from: www.dnrc.mt.gov/
licenses-and-permits/stream-permitting
This space is for all Department of Transportation and SPA 124 permits (government projects).
Project Name _________________________________________________
Control Number ________________________________ Contract letting date ________________________________________________
MEPA/NEPA Compliance Yes No If yes, #14 of this application does not apply.
ATTACH A PROJECT SITE MAP OR A SKETCH that includes: 1) the water body where the project will take
place, roads, tributaries, landmarks; 2) a circled “X” representing the exact project location. IF NOT CLEARLY
STATED ON THE MAP OR SKETCH, PROVIDE WRITTEN DIRECTIONS TO THE SITE.
C. PROJECT INFORMATION
1. TYPE OF PROJECT (check all that apply)
Bridge/Culvert/Ford Construction Fish Habitat Mining
Bridge/Culvert/Ford Removal Recreation (docks, marinas, etc.) Dredging
Road Construction/Maintenance New Residential Structure Core Drill
Bank Stabilization/Alteration Manufactured Home Placement of Fill
Flood Protection Improvement to Existing Structure Diversion Dam
Channel Alteration Commercial Structure Utilities
Irrigation Structure Wetland Alteration Pond
Water Well/Cistern Temporary Construction Access Debris Removal
Excavation/Pit Other _____________________________________________
2. PLAN OR DRAWING of the proposed project MUST be attached. This plan or drawing must include:
• a plan view (looking at the project from above) • a cross section or profile view
• dimensions of the project (height, width, depth in feet) • an elevation view
• location of storage or stockpile materials • dimensions and location of fill or excavation sites
• drainage facilities • location of existing or proposed structures, such as
• an arrow indicating north buildings, utilities, roads, or bridges
3. IS THIS APPLICATION FOR an annual maintenance permit? Yes No
(If yes, an annual plan of operation must be attached to this application – see “Information for Applicant”)
4. PROPOSED CONSTRUCTION DATE. Include a project timeline. Start date _____/_____/_____
Finish date_____/_____/_____ Is any portion of the work already completed? Yes No
(If yes, describe the completed work.)
5. WHAT IS THE PURPOSE of the proposed project?
6. PROVIDE A BRIEF DESCRIPTION of the proposed project.
7. WHAT IS THE CURRENT CONDITION of the proposed project site? Describe the existing bank condition,
bank slope, height, nearby structures, and wetlands.
8. PROJECT DIMENSIONS. How many linear feet of bank will be impacted? How far will the proposed
project encroach into and extend away from the water body?
9. VEGETATION. Describe the vegetation present on site. How much vegetation will be disturbed or covered
with fill material during project installation? (Agencies require that only vegetation necessary to do the work be
removed.) Describe the revegetation plan for all disturbed areas of the project site in detail.
10. MATERIALS. Describe the materials proposed to be used. Note: This may be modified during the permitting process. It is
recommended you do not purchase material until all permits are issued.
Cubic yards/Linear feet Size and Type Source
11. EQUIPMENT. List all equipment that will be used for construction of the project. How will the equipment
be used on the bank and/or in the water? Note: Make sure equipment is clean and free of weeds, weed seeds, and excess
grease before using it in the water waterway. To prevent the spread of aquatic invasive species, to the extent practical, remove mud
and aquatic plants from heavy machinery and other equipment before moving between waters and work sites, especially in waters
known to be infested with aquatic invasive species. Drain water from machinery and let dry before moving to another location.
12. DESCRIBE PLANNED EFFORTS TO MINIMIZE PROJECT IMPACTS. Consider the impacts of the
proposed project, even if temporary. What efforts will be taken to:
Minimize erosion, sedimentation, or turbidity?
Minimize stream channel alterations?
Minimize effects to stream flow or water quality caused by materials used or removal of ground cover?
Minimize effects on fish and aquatic habitat?
Minimize risks of flooding or erosion problems upstream and downstream?
Minimize vegetation disturbance, protect existing vegetation, and control weeds?
13. WHAT ARE THE NATURAL RESOURCE BENEFITS of the proposed project?
14. LIST ALTERNATIVES to the proposed project. Why was the proposed alternative selected?
D. ADDITIONAL INFORMATION FOR SECTION 404, SECTION 10, AND FLOODPLAIN PERMITS ONLY.
If applying for a Section 404 or Section 10 permit, fill out questions 1-3. If applying for a floodplain permit, fill out
questions 3-6. (Additional information is required for floodplain permits – See “Information for Applicant.”)
1. Will the project involve placement of dredged (excavated) and/or fill material below the ordinary high water
mark, in a wetland, or other waters of the US? If yes, what is the surface area to be filled? How many cubic
yards of fill material will be used? Note: Wetland delineations are required if wetlands are affected.
2. Description of avoidance, mitigation, and compensation (see Information for Applicant). Attach additional
sheets if necessary.
3. List the names and address of landowners adjacent to the project site. This includes properties adjacent to
and across from the project site. (Some floodplain communities require certified adjoining landowner lists).
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
4. List all applicable local, state, and federal permits and indicate whether they were issued, waived, denied, or
pending. Note: All required local, state, and federal permits, or proof of waiver must be issued prior to the
issuance of a floodplain permit.
5. Floodplain Map Number _____________________________
6. Does this project comply with local planning or zoning regulations? Yes No
E. SIGNATURES/AUTHORIZATIONS -- Each agency must have original signatures signed in blue ink.
After completing the form, make the required number of copies and then sign each copy. Send the copies
with original signatures and additional information required directly to each applicable agency.
The statements contained in this application are true and correct. The applicant possess’ the authority to undertake the
work described herein or is acting as the duly authorized agent of the landowner. The applicant understands that the
granting of a permit does not include landowner permission to access land or construct a project. Inspections of the
project site after notice by inspection authorities are hereby authorized.
APPLICANT (Person responsible for project): LANDOWNER:
Print Name: _____________________________ Print Name: _____________________________
______________________________________ ________________________________________________
Signature of Applicant Date Signature of Landowner Date
*CONTRACTOR/AGENT:
Print Name: ______________________________
________________________________________
Signature of Contractor/Agent Date
*Contact agency to determine if contractor signature is required.
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JOINT APPLICATION FOR PROPOSED WORK IN MONTANAS STREAMS, (Cascade County)

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Completed 25 January 2021

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