Wetland Site Inspection 2001 .r. �1 i� ats /� 1
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`i, N ,� 400 Slocum Road • P. O. Box 79399 `` a..Z• n 0(/ny
\<Is." Dartmouth, Massachusetts 02747-0985 - � ',�,.,0. ,
CONSERVATION COMMISSION
(508) 999-0722
A-1 Site Inspection Form FAX:(508) 999-0797
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Name of Person Making Request Date
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Mailing Address Street Location Of Property To Be/V�iiewed
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wri/ City/Town. State Zip Code /// Dartmouth Assessors Map and Lot Number
Telephone - Day Proposed Use of Land (Kduse, addit4n,garage. etc.)
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Telephone - Evening Signature of Pers>; twjMaking Request rt
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Name of Owner of Site To Be Viewed 1 Print Nand;
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Owner's address Signature of Ow r of Site to be Viewed
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Print Name
Site Inspection Fees:
1-5 Acres $50.00; 5-10 Acres $75.00. 10-100 Acres $200.00; Above 100 acres $400.00
All tiling forms are available in the Conservation Commission office,room 107 at the Dartmouth Tomn I fall,-UK)Slocum Rd. from
')AM --4PM Monday and S:45AM-4:301'M Tuesday through Friday.
For parcels from I to 5 acres onls',the Conservation Inspector is available to Ilag the wetland edge. I lowever it is the Applicant's
option to acquire the services of a private consultant to delineate the wetlands oil a parcel of that size. The Inspector has the right
to require the Applicant to obtain the services of a private consultant to perform a'%etlaild delineation on areas less than 5 acies
\%here abnormal site conditions or extensive use of soils evaluation would require an excessive amount of time be spent by the
Conservation Inspector in making a determination of the wetland areas present. Sites over 5 acres must be flagged by a wetland
scientist. botanist or other qualified person pnor to subnuttuig the A-I site inspection limn. The Conservation Inspector will then
review the !lagging in the field and make adjustments where necessary. the Conservation Couunission may require proof of the
qualifications of the person pertornmlg the delineation.
Note:The A-I Site Inspection is a prouxlure outlined in the I)artnnnith Wetlands Protection Bylaw It is a service available tiff the
purpose of Identilsing wetland areas on a site The issuance of this completed Site Inspection is NOT a final determination of
\\etland bounndanes or their 3unsdicttonal ,iatus wider the Massachusetts Wetlands Protection Act tMGI. Ch. Ill ;•3tli or ilie
Dartmouth Wetlands Protection 13yla\y t 111\ the issuance of a Determination of Applicability or Order of Conditions b\ the
Conservation t:onunission tinali/es the determination of\\enland boundaries and,or their iunsdictional status under these 1 al.\s
the completion III this Site lllcpei.non is not:111 author/anon to proceed\\itll\\or3. tins site inspection expires three t 11\ears horn
the date ,'I ISHiaille
CONSERVATION COMMISSION INSPECTOR COMMENTS AND RECOMMENDATIONS
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❑ No wetlands or other areas subject to the jurisdiction of the Conservation Commission exist on site or within 100 feet
of site. No other filing with the Conservation Commission required.
•
The prop sed`vl%ork is not_located within 100-feet of a wetland area. Other wetlands may exist on site. Any further
wor‘to biied•outside of inspected area requires the filing of an additional A 1.
❑ Wetlands exist on( North. South. East. —L4f site.Please refer to drawing(if provided by inspector)for location
information. All locations on sketch provided by inspector are approximate.
❑ Edge of wetland has been marked on site by Inspector. Flag numbers:
wet Through wet
Additional wetlands marked
wet Through wet • wet Through wet
wet Through wet • wet Through - wet
J Wetland delineated using: ] Vegetation only ❑ Soils and vegetation
Any activity (clearing, digging removal of vegetation. etc.) in a wetland or within 100 feet of a wetland requires a
permit from the Conservation Commission. No work shall begin until permit is received. This comnleted form
is not a permit.
A Rcouest for Determination should be filed with the Conservation Commission before anv work begins on site.
J A Notice of Intent should be filed with the Conservation Commission before any work begins on site.
J Coastal Bank exists on site. Engineer must delineate Coastal Bank per DEP Wetland Program Policy 92-1.
Delineation must be submitted to the Conservation Comnussion office.for review and approval.
100-. car flood plain may be present on site. Engineer or Dartmouth Building Deportment must determine if proposed
work is located within flood plain. If work is located in flood plain then a further filing with Conservation Commission
is required.
J A survey plan of the wetland delineation should be submitted to the Conservation Commission office.
J Due to abnormal site conditions and'or the necessity of gathering an extensive amount of soils information to
adequately descnbe the wetlands on site the applicant must obtain the services of a private consultant to perform a
‘vctland delineation. The delineation must be submitted to the Conservation Commission for review and approval.
#41 Other Comments:
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Date o Issuance Michael O'Reilly
Environmental Affairs Coordinator
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C nscr.-ation Officer
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