Wetland Site Inspection 1997 •
400 Slocum Road • P O. Box 9399
,e North Dartmouth, fvcassachu-setts-O4Z47 `y Q
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A-1 SITE INSPECTION FORM Ca's�S4t�;��)d;: t�;,:
SERVATION COMMISSION (508)999-0722
2-(2 714 10.-' S7207
Name of Person Making Request Date
27
o aCA,G 33cZ • ( P-cTT�+� l
Address of Applicant Street Location of
Property ,0 eo
4}c, ) `�.�- f �. 0Z7 y /-- Z7 £F z�
ty'\T wn, Citate , Zip Plat and Lot Number
3 -2'7 7 257 --/Xe;5
721ephot: _ ( Da,; k Evening ) Proposed Use of Land
( Dwel ' 1g, Additi i e'-c . )
:-crier Name Signature of Owner or
Owners Representative
Add:: =s Signature of Applicant
L,c(2__T7: 11.'4 _)F 771OPEP.T'! : Please attach a site plan . If a site plan
is not available , a hand drawn map showing the exact
location and size of property to be inspected is acceptable .
The map shall include the following information : street
name , hcu_e number on abutting lots , property bound
locations , and any natural or man-made features which will
allow the inspector to find the site . tire the space
provide below to draw a map or attach an extra sheet .
Property boundaries should be clearly marked in the field
<<�� requesting site inspection .
.. "`w zw.wunrimuaTIONS
Wetlands exist on (North, South, East, West) of site.
_ Edge of wetland has been marked on site by Inspector. Flag numbers -
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.
— A Notice of Intent should be filed with the Conservation Commission before any
work begins on site.
A Request for Determination 'should be filed with the Conservation Commission
be ore any work begins on site.
No wetlands or other areas subject to the jurisdiction of the
commission exist on site orConservationtoe
filed with the Conservation Commission. .feet of site. No forms need to be
A survey plan of the wetland delineation should be submitted to the
Conservation Commission office.
Other Comments:
Note: The A-1 Site Inspection is a procedure outlined in the Dartmouth Wetlands
Protection Bylaw. It is a service available for the purpose of identifying
wetland areas on a site. The issuance of this completed Site Inspection is NOT
a final determination of wetland boundaries or their jurisdictional status under
the iassachusetts Wetlands Protection Act (MGL Ch. 131
St
Wetlands Protection Bylaw. Only the issuance of a Dete i) or Applicabilityon of pp Dartmouth
or Orcer of Conditions by the Conservation Commission finalizes the determination
of wetland boundaries and\or their jurisdictional status under these Laws. The
comc1.etion of this site Ins ection is not an authorization to roceed with work.
This site inspection expires three (3) years from the date of issuance (shown
below) .
All filing forms are available in the conservation commission office, room 107
at the Dartmouth Town Hall, 400 Slocum Rd. from 9AM - 4PM Mondays and 8:45AM -
4:30PM Tuesday through Friday.
Site Inspection Fees:
1-5 Acres $50.00; 5-10 Acres $75.00; 10-100 Acres $200.00;
Above 100 acres $400. 00
The Conservation Inspector will flag the wetland edge for sites from 1-5 acres
only. The Conservation commission reserves the right to refuse to perform a site
inspection on areas less than 5 acres where abnormal site conditions 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
submitting of site inspection. The Conservation Inspector fied will personthen reviewrthto
e
flagging in the field and make adjustments where necessary. The Conservation
Commission may require proof of the qualifications of the person performing the
delineation on sites larger than 5 acres.
Date����ot :ssuance
M charm _ J. O Reillu
Environmental Affairs Coordinar r
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