Joint Federal and State Application Form
For Activities Affecting Waters of the United States
Or Critical Areas of the State of South Carolina
This Space for Official Use Only
Application No._______________________________
Date Received________________________________
Project Manager______________________________
Watershed # _________________________________
33 USC 401, 33 USC 403, 33 USC 407, 33 USC 408, 33 USC 1341, 33 USC 1344, 33 USC 1413 and Section 48-39-10 et. Seq of the South Carolina Code of Laws.
These laws require permits for activities 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. The Corps of Engineers and the State of South Carolina have established a joint application
process for activities requiring both Federal and State review or approval. Under this joint process, you may use this form, together with the required drawings and supporting
information, to apply for both the Federal and/or State permit(s).
Drawings and Supplemental Information Requirements: In addition to the information on this form, you must submit a set of drawings and, in some cases,
additional information. A completed application form together with all required drawings and supplemental information is required before an application can
be considered complete. See the attached instruction sheets for details regarding these requirements. You may attach additional sheets if necessary to provide
complete information.
11. Agent Last Name (agent is not required):
3. Applicant Company Name:
4. Applicant Mailing Address:
14. Agent Mailing Address:
8. Applicant Area Code and Phone No.:
18. Agent Area Code and Phone No.:
22. Project Street Address:
28. Property Size (acres):
31. Directions to Project Site (Include Street Numbers, Street Names, and Landmarks and attach additional sheet if necessary):
32. Description of the Overall Project and of Each Activity in or Affecting U.S. Waters or State Critical Areas (attach additional sheets if
needed)
33. Overall Project Purpose and the Basic Purpose of Each Activity In or Affecting U.S. Waters (attach additional sheets if needed):
34. Type and quantity of Materials to Be Discharged
Dirt or Topsoil: _________ cubic yards
Clean Sand: _________ cubic yards
Mud: _________ cubic yards
Clay: _________ cubic yards
Gravel, Rock, or Stone: _________ cubic yards
Concrete: _________ cubic yards
Other (describe): _________ cubic yards
TOTAL: _________ cubic yards
35. Type and Quantity of Impacts to U.S. Waters (including wetlands).
Filling: ___________ acres sq.ft. _________ cubic yards
Backfill & Bedding: ___________ acres sq.ft _________ cubic yards
Landclearing: ___________ acres sq.ft _________ cubic yards
Dredging: ___________ acres sq.ft. _________ cubic yards
Flooding: ___________ acres sq.ft. _________ cubic yards
Draining/Excavation: ___________ acres sq.ft. _________ cubic yards
Shading: ___________ acres sq.ft. _________ cubic yards
TOTALS: _____________ acres___________ sq.ft. _________ cubic yards
Town of Hilton Head Island
ScottL@hiltonheadislandsc.gov
ccreed@olsen-associates.com
Post Hurricane Matthew - South Beach Lane Emergency Beach Fill Project
One Town Center Court, Hilton Head Island, SC
Atlantic Ocean and Calibogue Sound
I-95 to US 278 East to Hilton Head Island. Continue on Hwy 278 for about 10.5 miles.
Turn Right onto Wexford Drive. Take first Right in to Town Hall Parking Lot.