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(continued) pplication.
7. Four copies of exhibits and drawings depicting the project or use.
8. At least two color photographs (polaroids or snapshots are acceptable) showing different views of the project site. Include captions which explain what the photograph is depicting.
9. The name and address of the owner of the proposed project or use if different from the person filing the application.
You should include with your application any additional information that would be helpful in evaluating your proposed project or use.
The application must be signed and dated.
Your completed application may be mailed or delivered in person to:
The Reclamation Board

Attention: Floodway Protection Section

1416 Ninth Street, Room 455-8

Sacramento, California 95814

The Board has adopted standards for work which encroaches into the area under its jurisdiction. Copies of the standards are available upon request. A typical levee cross section and terminology are presented in Exhibit 1.
Minimum Requirements and Format for Drawings
1. The following information is required to evaluate the work described in your application. Additional information may be required depending upon the nature of the project.
A. The title block of each sheet should identify the proposed activity and include the name of the applicant, number of the sheet, total number of sheets in the set, and date the drawing was prepared.
B. The name of the stream, river mile, scale, north arrow, datum reference, and other information as required.
C. The exact location of the proposed project in relation to identifiable landmarks.
D. Plan and elevation views of the proposed project or use and the proximity of the proposed project or use in relation to existing facilities, property lines, levees, streams, etc.
E. Drawings of levee cross sections or profiles must indicate the elevations of levee crowns, toes, low-water surface, and design flood plane. These drawings should include horizontal and vertical scales and must be referenced to a known elevation datum.
2. Please use the following format:
A. Prepare the drawings on 8-1/2-by-11-inch sheets (when possible) in accordance with the general format depicted in Exhibits 2, 3, and 4.
B. Allow a 1-inch binding margin on the top side of each sheet.
C. Because additional copies of the drawings may have to be reproduced photographically, color shading cannot be used. Drawings must show shading as dot shading, cross hatching, or similar graphic symbols.
Application Processing
Upon receipt of an application, a general review is made to determine if it is adequately complete to begin processing. If the application is found to be complete, it will be assigned a number and a letter will be sent to the applicant acknowledging receipt of the application. The Board will send a notice of the pending application to the adjacent property owners. If, during the review process, the application is found to be incomplete, it will be returned or the applicant will be advised by letter of the deficiencies in the application. If these deficiencies are not corrected within a reasonable time limit, processing of the application will be terminated.
The applicant may be notified of a need for additional studies.
A copy of the application is sent to the U.S. Army Corps of Engineers for review and comment.
The Board staff performs some level of environmental review of the potential impacts of the proposed project or use.
The project or use described in the permit issued on each approved application is subject to 12 general conditions. A number of special conditions may be added to the approved permit depending on the nature of the proposed activity.
The majority of applications filed are approved by the Board's General Manager. If the General Manager denies an application, the applicant has the right to appeal to the Board. Requests for Board consideration should be in writing and should include a statement of facts as to why an appeal is being made to the Board.
Applications which must be considered by the Board are placed on the agenda of the next regular Board meeting. The applicant and all interested parties are notified of the meeting and may appear and present their views to the Board for its consideration.
After an application has been approved by the Board, any requests for revisions to the proposed or completed project which have not been approved by the Board must be submitted in writing to the Board for approval. Revised applications are processed in the same manner as new applications.
Acceptance of a Permit
You must notify the Department of Water Resources ten days before construction begins by mailing the pre-addressed start card furnished by the Board when the permit is issued. This card will contain the current address and telephone number of the Department of Water Resources' Flood Project Inspection Section which provides inspection services on behalf of the Board. The beginning of any work described in the permit constitutes acceptance by the applicant that work will be done in compliance with the general and special conditions listed in the permit.
Inquiries about procedures or other details may be made in person or by correspondence to The Reclamation Board, Attention: Floodway Protection Section, 1416 Ninth Street, Room 455-8, Sacramento, California 95814; by FAX at (916) 653-5805; or by calling (916) 653-5726. Please include the Board's application number when inquiring about an application.

STATE OF CALIFORNIA

THE RESOURCES AGENCY

THE RECLAMATION BOARD

SAMPLE 00000 GM SAMPLE
PERMIT NO.
This Permit is issued to:
Mr. John Doe
John Doe Irrigation District
1234 Any Street
Anywhere, California 00000
To install a 60-inch-diameter water pipeline within a 78-inch-diameter casing and a 24-inch-diameter water pipeline within a 42-inch-diameter casing under Any Stream. The project is located in the City of Anywhere approximately 1,400 feet upstream from The Road. Section 00, TOS, ROOE, M.D.B.&M., Any Stream, Sacramento County
NOTE: Special Conditions have been incorporated herein which may place limitations on and/or require modification of your proposed project described above.
The Reclamation Board, on the _________________________________ day of _________________________, 19____, approved this application and the plans attached thereto. Permission is granted to proceed with the work described in this application, which is incorporated herein by reference, subject to the following General and Special Conditions.
(SEAL)
Dated: _____________________ ____________________________
General Manager
GENERAL CONDITIONS:
ONE: This permit is issued under the provisions of Sections 8700 - 8723 of the Water Code.
TWO: Only work described in the subject application is authorized hereby.
THREE: This permit does not grant a right to use or construct works on land owned by the Sacramento and San Joaquin Drainage District or on any other land.
FOUR: The approved work shall be accomplished under the direction and supervision of the State Department of Water Resources, and the permittee shall conform to all requirements of the Department and The Reclamation Board.
FIVE: Unless the work herein contemplated shall have been commenced within one year after issuance of this permit, the Board reserves the right to change any conditions in this permit as may be consistent with current flood control standards and policies of The Reclamation Board.
SIX: This permit shall remain in effect until revoked. In the event any conditions in this permit are not complied with, it may be revoked on 15 days' notice.
SEVEN: It is understood and agreed to by the permittee that the start of any work under this permit shall constitute an acceptance of the conditions in this permit and an agreement to perform work in accordance therewith.
(over)
EIGHT: This permit does not establish any precedent with respect to any other application received by The Reclamation Board.
NINE: The permittee shall, when required by law, secure the written order or consent from all other public agencies having jurisdiction.
TEN: The permittee is responsible for all personal liability and property damage which may arise out of failure on the permittee's part to perform the obligations under this permit. If any claim of liability is made against the State of California, or any departments thereof, the United States of America, a local district or other maintaining agencies and the officers, agents or employees thereof, the permittee shall defend and shall hold each of them harmless from each claim.
ELEVEN: The permittee shall exercise reasonable care to operate and maintain any work authorized herein to preclude injury to or damage to any works necessary to any plan of flood control adopted by the Board or the Legislature, or interfere with the successful execution, functioning or operation of any plan of flood control adopted by the Board or the Legislature.
TWELVE: Should any of the work not conform to the conditions of this permit, the permittee, upon order of The Reclamation Board, shall in the manner prescribed by the Board be responsible for the cost and expense to remove, alter, relocate, or reconstruct all or any part of the work herein approved.
SPECIAL CONDITIONS:
THIRTEEN: That all work shall be in accordance with the submitted drawings and specifications dated December 1991 except as modified by special permit conditions herein. No further work, other than that covered by this permit, shall be done in the area without the prior approval of The Reclamation Board.
[FNa1] FOURTEEN: That in the event trees and brush are cleared, they shall be completely burned or otherwise removed from the overflow area of Dry Creek, and no downed trees or brush shall be allowed to remain in the floodway during the flood season between November 1 and April 15.
[FNa1] FIFTEEN: That no excavation shall be made or allowed to remain in the creek banks between November 1 and April 15.
SIXTEEN: That the backfill material for the bore pit and receiving pit excavation shall be placed in layers and compacted to a density equal to that of the adjacent undisturbed material.
SEVENTEEN: That the work area shall be restored to at least the same condition that existed prior to commencement of work.
EIGHTEEN: That the permittee shall assume all responsibility for protection, relocation, or removal of the permitted project works if required by the Board.
NINETEEN: That the applicant shall provide inspection services acceptable to the Board. A civil engineer registered in the State of California shall certify that all work was thoroughly inspected and performed in accordance with the submitted plan drawings, specifications, and permit conditions.
TWENTY: The permittee shall notify the Department of Water Resources by telephone, (916) 445-6386, at least ten working days prior to start of work.
[FNa1] November 15 to July 20 depending on location of stream.
State of California The Resources Agency
THE RECLAMATION BOARD

Application No.___________________

(For Office Use Only)

APPLICATION FOR A PERMIT

1. Description of proposed work: _______________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
2. Location: ____________County, in Section ____________________
(N) (E)
Township: __________(S), Range __________(W), M.D.B.&M.
3. _________________________________ of ________________________
Name of Applicant Address
_____________________________________________________________
City State ZIP Code Telephone Number
_________________
FAX Number
4. Endorsement: (of Reclamation District)
We, the Trustees of _________________________________________
District Name and Number
approve this plan, subject to the following conditions:
[ ] Conditions listed on back of this form [ ] Conditions Attached [ ] No Conditions
______________________________ _______________________________
Trustee Date Trustee Date
______________________________ _______________________________
______________________________ _______________________________
5. Names and addresses of adjacent property owners sharing a common boundary with the land upon which the contents of this application apply. If additional space is required, list names and addresses on back of the application form or an attached sheet.
________________________________________________________________
Name Address ZIP Code
________________________________________________________________
________________________________________________________________
________________________________________________________________
6. Has an environmental determination been made of the proposed work under the California Environmental Quality Act of
1970? [ ] Yes [ ] No [ ] Pending
If yes or pending, give the name and address of the lead agency and State Clearinghouse Number:
_______________________________________________________________
_______________________________________________SCH NO._________
DWR 3615 (Rev. 4/94) Side A
7. When is the project scheduled for construction? _______________ __________
8. Please check exhibits accompanying this application.
A. [ ] Map showing the location of the proposed work.
B. [ ] Drawings showing plan and elevation views of the proposed work, scale, materials of construction, etc.
C. [ ] Drawings showing the cross section dimensions and elevations of levees, berms, stream banks, flood plain, low flow, etc.
D. [ ] Drawings showing the profile elevations of levees, berms, flood plain, low flow, etc.
E. [ ] Photograph depicting the project site.
9. Is the applicant acting for the owner of the proposed works? [ ] Yes [ ] No
If yes, the name, address and telephone number of the owner is
________________________________________________________________
________________________________________
Signature of Applicant Date
For additional information:
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
DWR 3615 (Rev. 4/94) Side B
ENVIRONMENTAL ASSESSMENT QUESTIONNAIRE

FOR APPLICATIONS FOR RECLAMATION BOARD ENCROACHMENT PERMITS

This environmental assessment questionnaire must be completed for all Reclamation Board applications. Please provide an explanation where requested. Incomplete answers may result in delays in processing permit applications. Failure to complete the questionnaire may result in rejection of the application.
1. Has an environmental assessment or initial study been made or is one being made by a local or State permitting agency in accordance with the California Environmental Quality Act?
Yes __________ No __________. If yes, identify the Lead Agency, type of document prepared or which will be prepared, and the State Clearinghouse number:
2. Will the project require certification, authorization or issuance of a permit by any local, State, or federal environmental control agency?
Yes __________ No __________. List all other governmental permits or approvals necessary for this project or use, including U.S. Army Corps of Engineers' 404 and Section 10 permits, State Water Quality Certification, Department of Fish and Game 1600 agreement, etc. Attach copies of all applicable permits.
3. Give the name and address of the owner of the property on which the project or use is located.
4. Will the project or use require issuance of a variance or conditional use permit by a city or county?
Yes __________ No __________. Explain:
5. Is the project or use currently operating under an existing use permit issued by a local agency?
Yes __________ No __________. Explain:
6. Describe all types of vegetation growing on the project site, including trees, brush, grass, etc.
7. Describe what type of wildlife or fish may use the project site or adjoining areas for habitat, food source, nesting sites, source of water, etc.
8. Has the Department of Fish and Game, U.S. Fish and Wildlife Service, or National Marine Fisheries Service been consulted relative to the existence of, or impacts to, threatened or endangered species on or near the project site?
Yes __________ No __________. Explain:
9. Will the project or use significantly change present uses of the project area?
Yes __________ No __________. Explain:
10. Will the project result in changes to scenic views or existing recreational opportunities?
Yes __________ No __________. Explain:
11. Will the project result in the discharge of silt or other materials into a body of water?
Yes __________ No __________. Explain:
12. Will the project involve the application, use, or disposal of hazardous materials?
Yes __________ No __________. If yes, list the types of materials, proposed use, and disposal plan. Provide copies of all applicable hazardous material handling plans.
13. Will construction activities or the completed project generate significant amounts of noise?
Yes __________ No __________. Explain:
14. Will construction activities or the completed project generate significant amounts of dust, ash, smoke, fumes, or odors?
Yes __________ No __________. Explain:
15. Will the project activities or uses involve the burning of brush, trees, or construction materials, etc.?
Yes __________ No __________. Explain, and identify safety and air pollution control measures:
16. Will the project affect existing agricultural uses or result in the loss of existing agricultural lands?
Yes __________ No __________. Explain:
17. Have any other projects similar to the proposed project been planned or completed in the same general area as the proposed project?
Yes __________ No __________. Explain and identify any other similar projects:
18. Will the project have the potential to encourage, facilitate, or allow additional or new growth or development?
Yes __________ No __________. Explain:
19. Will materials be excavated from the floodplain?
Yes __________ No __________.
THE REMAINING QUESTIONS MUST ONLY BE ANSWERED IF THE ANSWER TO QUESTION NO. 19 WAS "YES." IF THE ANSWER TO QUESTION NO. 19 WAS "NO," YOU DO NOT NEED TO COMPLETE THE REMAINING QUESTIONS.
A. What is the volume of material to be excavated?
Annually_______________ Total_____________________________
B. What types of materials will be excavated?
C. Will the project site include processing and stockpiling of material on site?
Yes __________ No __________. Explain:
D. What method and equipment will be used to excavate material?
E. What is the water source for the project?
F. How will waste materials wash water, debris, and sediment be disposed of?
G. What is the proposed end land use for the project site?
H. Has a reclamation plan been prepared for this site in accordance with the Surface Mining and Reclamation Act of 1975?
Yes __________ No __________. If yes, please attach a copy.