A. Type of Environmental Resource Permit Requested (Select One):
General Permit
Mitigation Bank (construction)
Mitigation Bank (conceptual)
Individual
Conceptual
Request for Exemption Verification
Extension of Permit Duration
Formal Wetland Determination
Infomal Wetland Determination
Minor Modification
Minor Modification w/Transfer
B. Type of authorization being requested (Select One):
Construction or operation of new works, activities and/or a stormwater management system; or a new Conceptual Approval
alteration, maintenance, or repair of previously permitted works, activities or Stormwater Management System
Abandonment or removal of works, activities and/or stormwater management system
Alteration or operation of an existing stormwater management system which was not previously permitted by the DEP or WMD
Operation only permit
Construction of additional phases of a permitted work, activity and/or stormwater management system
Request for exemption
Extension of permit duration
New Wetland Determination
Reissuance of Formal Wetland Determination
Provide previous permit number: 48-00714-P
C. How many components are being affected? : 0
Components include service area,credit assessment; success or release criteria; hydrologic structures or alterations; construction or mitigation design that does not increase the project area; elimination of lands; or monitoring or management plans.
State 404 Authorization
By checking this box, I am indicating intent to apply for a State 404 Authorization, which refers to dredge and fill program permits or activities within waters of the United States. Please complete and attach Section I as part of this submittal.
By checking this box, I hereby voluntarily waive, in accordance with Rule 62-330.090(8), F. A. C. the agency action deadlines in section 5.5.3 of Volume I in the event my project also requires a State 404 Program authorization (other than an exemption) under Chapter 62-331, F. A. C, and request that the agency actions for the ERP and State 404 Program authorizations be issued at the same time. (This is strongly recommended to ensure consistency, and to reduce the potential need for project modifications to resolve inconsistencies that may occur when the agency actions are issued at different times.) if this box is checked and the Agency(ies) determines that no State 404 Program authorization is required, the Agency will continue to abide by section 5.5.3 of Volume I.
D. Type of Activity you are applying(Check all that apply):
For Activities in, on or over wetlands or other surface waters, or within 25 feet of a wetland or surface water. Wetlands and Surface waters are defined in Chapter=62-340.Examples include dredging, filling, outfall structures, docks, piers, over-water structures, shoreline, stabilization, mitigation, reclamation, restoration/enhancement (Section C)
Activities within navigable or flowing surface waters such as multi-slip dock or marina, dry storage facility, dredging, bridge, breakwaters, reefs, or other offshore structures (Section D)
Construction or alteration of a stormwater management system serving residential, commercial, transportation, industrial, agricultural, or other land uses, or a solid waste facility (excluding mines that are regulated by DEP) (Section E)
Activities that are (or may be) located within, on or over state-owned submerged lands (See Chapter 18-21). (Section F)
Creation or Modification of Mitigation Bank (refer to Chapter=62-342). (Section G)
E. For activities in, on or over wetlands or other surface waters, check type of federal dredge and fill permit requested
Individual
Programmatic General
Letter of Permission
General
Nationwide
Not Applicable
F. Is this project part of a larger plan of development or sale?
Yes No
G. Impervious or semi-impervious area excluding wetlands or other surface waters (if applicable):0.47 acres
H. Volume of water the system is capable of impounding (if applicable):N/A
OWNER(S) OF LAND:
ENTITY TO RECEIVE PERMIT (IF OTHER THAN OWNER):
NAME:
NAME: Justice, Scott
ADDRESS:
ADDRESS: P.O. Box 10,000
CITY,STATE,ZIP:
CITY,STATE,ZIP: Lake Buena Vista, FL 32830
COMPANY AND TITLE
COMPANY AND TITLE: Walt Disney Parks and Resorts U.S., Inc.
TELEPHONE: FAX:
TELEPHONE: FAX:
AGENT AUTHORIZED TO SECURE PERMIT (IF AN AGENT IS USED):
CONSULTANT (IF DIFFERENT FROM AGENT):
NAME:
NAME: Germana, Christopher
COMPANY AND TITLE:
COMPANY AND TITLE: Germana Engineering and Associates, LLC
ADDRESS:
ADDRESS: 1120 W. Minneola Avenue
CITY,STATE,ZIP:
CITY,STATE,ZIP: Clermont, FL 34711
TELEPHONE: FAX:
TELEPHONE: FAX:
Project Location Details
Project Name: MK Park 2 Roadside Site Modifications
Project Acreage: 43.25
Irrigated Acreage:
Number of new or modified boat slips:
Total acres of work in, on or over wetlands or surface waters: 27.57
Project Address:
City, Town or Village: Bay Lake
Zip:
Latitude:
Longitude:
Directions to site from nearest major intersection:
County: ORANGE
Sections
Township
Range
Land Grant
2
24
27
Tax Parcel Id No
02-24-28-0000-00-016
11-24-27-0000-00-004
Applicant Signature/Owner Authorization
Scott Justice
OWNER/APPLICANT
06/21/2021
Date
Statement Of Agreement
By signing this application form, I am applying for, or I am applying on behalf of the applicant, for the permit and any proprietary authorizations identified above, according to the supporting data and other incidental information filed with this application. I am familiar with the information contained in this application and represent that such information is true, complete and accurate. I understand this is an application and not a permit, and that work prior to approval is a violation. I understand that this application and any permit issued or proprietary authorization issued pursuant thereto, does not relieve me of any obligation for obtaining any other required federal, state, water management district or local permit prior to commencement of construction. I agree, or I agree on behalf of my corporation, to operate and maintain the permitted system unless the permitting agency authorizes transfer of the permit to a responsible operation entity. I understand that knowingly making any false statement or representation in this application is a violation of Section 373.430, F.S. and 18 U.S.C. Section 1001.
I either own the property described in this application or I have legal authority to allow access to the property, and I consent, after receiving prior notification, to any site visit on the property by agents or personnel from the Department of Environmental Protection, the Water Management District and the U.S. Army Corps of Engineers necessary for the review and inspection of the proposed project specified in this application. I authorize these agents or personnel to enter the property as many times as may be necessary to make such review and inspection. Further, I agree to provide entry to the project site for such agents or personnel to monitor permitted work if a permit is granted.
Prepared by:
Name:
Katherine Luetzow
Agency of Employment:
Position:
Email Address:
kluetzow@rcid.org
Phone Number:
407-828-2954
Signature Date:
06/21/2021
Existing or Proposed Permits
Describe in general terms the proposed project, system, or activity.
Construction of fenced gravel yard and access, concrete slabs, select wetland clearing and landscape improvements.
Please identify by number any MSSW/Wetland resource/ERP/ACOE Permits pending, issued or denied for projects at the location, and any related enforcement actions.
Agency
Date
No.Type of Application
Action Taken
Note:The following information is required only for projects proposed to occur in,on or over wetlands that need a federal dredge and fill permit and/or authorization to use state owned submerged lands and is not necessary when applying solely for an Environmental Resource Permit. Please provide the names, addresses and zip codes of property owners whose property directly adjoins the project (excluding applicant). Please attach a plan view showing the owner's names and adjoining property lines. Attach additional sheets if necessary.