TOWN OF EAST HAMPTON
INLAND WETLANDS & WATERCOURSES AGENCY
Date____________ PAID_____________
IWWA___________ CHECK__________
LOCATION________________________________________________________________________MAP______BLK______LOT______
SUB NAME/ACTIVITY_____________________________________________________________________________ZONE___________
APPLICANT_______________________________________________________________________PHONE______________________
ADDRESS________________________________________________________________Fax_________________________
OWNER__________________________________________________________________________PHONE______________________
ADDRESS________________________________________________________________Fax _________________________
CONTACT PERSON( IF OTHER THAN APPLICANT)_________________________________________________PHONE______________ ADDRESS_____________________________________________________________________________________Fax________________
SURVEYOR/ENGINEER_____________________________________________________________PHONE______________________
ADDRESS__________________________________________________________________________ Fax_________________
APPLICATION TYPE
ACTIVITY CODE #____________________ ACTIVITY PURPOSE CODE #_________________
1. Filling |
A. Residential Improvement by Homeowner |
2. Excavation |
B. New Residential Development for Single Family Units |
3. Land Clearing/grubbing |
C. New Residential Development for multi-family/condos |
4. Stream channelization |
D. Commercial/Industrial Uses |
5. Stream stabilization |
E. Municipal Improvements |
6. Stream clearance (removal of debris) |
F. Utility Company Improvements |
7. Culverting (no roadway)(piping) |
G. Agriculture, forestry or conservation |
8. Underground Utilities (no other activity) |
H. Wetland Creation/Restoration |
9. Roadway Construction |
I. Storm Water/Flood Control |
10. Drainage Improvements |
J. Erosion/Sedimentation Control |
11. Pond dredging/dam construction |
K. Recreation/ Boating/ Navigation |
12. Activity in buffer/setback area |
L. Routine Maintenance |
13. Other |
|
Project Description
SITE AREA ACTIVITY
Total Acreage of property__________________Acres ______________Completion of DEP Report Form
Application with no regulated activities
Site Plan________________$ 40.00 Subdivision ______________________$60.00
Forestry ______________________________ $100.00
+ regulated activity fee where applicable + crossing and activity fee where applicable
Regulated Upland Area (wetbelt) Excavation & Fill
Fill Proposed……… ______________ Cubic Yards _______________Sq Ft
Excavation Proposed ______________ Cubic Yards _______________ Sq Ft
Location where excavated material will be placed: On site______________Off site:_________________
Stream Alteration Lineal Feet……_____________ Feet
Wetlands excavation & Fill
Fill Proposed……… ______________ Cubic Yards _______________Sq Ft
Excavation Proposed ______________ Cubic Yards _______________ Sq Ft
Location where excavated material will be placed: On site______________Off site:_________________
Mitigation Measures
Wetlands or Watercourses Created _____________ Square Ft ______________ Acres
Total area altered
Upland Area _______________Square feet ______________ Acres
Wetlands _______________Square feet ______________ Acres
Total Area _______________Sqare feet _______________ Acres
REGULATED USES
Residential (upland) ________________ + significant activity fee if applicable , + wetland impact fee if applicable
Commercial (upland) _________________ + significant activity fee if applicable , + wetland impact fee if applicable
Subdivision
Residential _________________
Commercial _________________
Wetland Impact Fee _________________ Application must be completed in FULL
In order to be accepted by the Agency
Sormwater Discharge
# of acres ____________ _________________
Detention/Retention Ponds
# of ponds _____________ _________________
Bioretention Gardens
# of Gardens___________ __________________
Watercourse Crossing
Sq ft of impact ____________ _________________ + $ 50.
Seawalls
Linear Ft.________________ __________________ + significant activity fee if applicable
Pond Dredging
Square ft._______________ ___________________
Map amendment (wetlands deliniation only) ________________________
Modifications Residential ________________ + $25
Subdivision ________________ + $ 50
Commercial ________________ + $ 75
Significant Activity
(Public Hearing ) Residential ________________
Sur Charge Subdivision ________________
Commercial ________________
State Filing Fee ___$ 30.00_______
Authorized Agent Fee ___$ 20.00_______ TOTAL FEES _________________________
Signature of Applicant__________________________________ Signature of Property Owner________________________________
Rev 7-5-04
| 
