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Get Permit# Basin# Modgrid# W.a.p.# Application For Permit To ...

N Date: /20 / Construction Date: /20 / Construction date is: (Check One) Estimated Scheduled IMPOUNDMENT LOCATION: Please attach a Project Site Map showing the proposed location of impoundment (s) and maximum pool (s), at a sufficient scale to allow accurate review of site's features, plotted on a U.S. Geological Survey 7 1/2 minute topographic quadrangle and a County Soils based map. Copies of construction plans must be submitted when available. PURPOSE OF IMPOUNDMENT?: (Check Only One) Conse.

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