USCG PERMIT APPLICATION REVIEW CHECKLIST Application and Narrative

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10 Park Plaza, Room 4260 ● Boston, Massachusetts 02116 ● (617) 973-7434 ● (617) 973-8879
USCG PERMIT APPLICATION REVIEW CHECKLIST
Application and Narrative
Applicant
Name
Address
Telephone Number
Consultant
Name
Address
Telephone Number
Written Authorization for the Consultant to Act on the Applicant’s Behalf
Project Information
Location
Name of the Waterway That the Bridge Crosses
Number of Miles and Kilometers Above the Mouth of the Waterway Where the
Bridge Is Located
City(ies) or Town(s), County, and State Where the Bridge Is Located At, Near, or
Between
Description
Purpose
Authority Information
The Primary Authority for the Construction of the Bridge and Under What
Legislative Authority the Bridge Is Being Built
The Legislative Authority for the Existing Bridge If It Is to Be Replaced
If you do not own the existing bridge, which is being replaced or modified, then
include a signed statement from the bridge owner authorizing the removal or
modification work.
International Bridges (If Applicable)
The International Bridge Act of 1972, or a copy of the Special Act of Congress if
constructed prior to 1972, should be cited as the legislative authority for
international bridge construction.
Presidential approval should be obtained from the State Department prior to
issuing a Coast Guard bridge permit under the International Bridge Act of 1972.
Proposed Clearances and Elevations
Horizontal and Vertical Clearances, in the Navigation Span(s) Measured at Mean
High Water, 2% Flowline, or Other Appropriate Datum
Elevation of Mean High Water, the 2% Flowline, or Other Appropriate Datum
Depth and Width of the Waterway at the Appropriate Elevation
Existing Bridge Structure at the Bridge Site
Owner of the Bridge
Type of Bridge (Drawbridge, Fixed, etc.)
Mile Point and Navigational Clearances, in Linear and Metric Equivalents
Removal of a Bridge(s) (If Applicable)
Extent of Removal
Time Needed for Removal
Construction Activity
Type and Source of Project Funding
Scheduled Construction Commencement Date
Anticipated Completion Date
Summary of Maintenance of Traffic During Construction Activities
List the Anticipated Construction Sequence
Environmental Effects (If Applicable)
Alternatives to the Proposed Project
Changes to the Floodplain
Impacts to Wetlands and Land Under Water
Identify any public parks, recreation areas, natural habitats, historic sites, or
cultural sites located within one half mile of the project site.
Endangered Species
Essential Fish Habitat Assessment (need copy of plan)
Wild and Scenic Rivers
Prime or Unique Farmland
Compliance to the Statewide Implementation Plan (SIP)
Clean Air
Status of Noise Levels
Will there be any displacement of homes or businesses?
Fulfillment of Section 4 (f) – Section 106 (within ½ mile of project area)
Environmental Justice
Required Authorizations
State Authorizations
Coastal Zone Management Consistency Certification
Water Quality Certification (DEP)
-A copy of your CZM and WQC application should be submitted to us as soon as possible,
preferably along with your permit application.
-After you receive your CZM concurrence and WQC they should be immediately sent to us
because your permit can not be issued without them in the case file.
-If a WQC or CZM concurrence is not required for your project we will need a written statement
from CZM and or DEP indicating it is not required.
Other Federal Agencies with Jurisdiction over the Proposed Project
Agency
Permits or Type of Approvals Required for the Project
Fill (If Applicable)
General Composition of the Fill
Amount of Fill Above and Below Mean High Water (MHW) or Ordinary High Water
(OHW) in Cubic Yards
Acreage of Wetlands Impacted and Types of Vegetation Affected
Adjacent Property Owners Within A ½ Mile Radius
Names
Addresses
Underlying Studies, Reports, and Other Information
Estimated Cost of Proposed Project
Estimated Total Value of Yearly Commercial Shipping on the Waterway Affected
by the Bridge
Construction Plans for CG application
GENERAL
Submit one original set of plans on mylar or linen size 8 ½ X 11 inches. Submit
fewest number of sheets possible, showing significant structural details. Plans
must be of good reproducible quality.
Each drawing must have simple title, date and number (e.g., sheet 1 of 2, sheet
2 of 2) in lower right hand corner.
Show graphic scale and north arrow on each individual plan sheet.
All dimensions and distances must be shown in both English and metric
State government datum used in plan and elevation views and location of
measurement systems.
datum. Datum utilized should be the same for all drawings submitted. Provide
survey notes or report showing calculations used to derive elevations and
identify referenced tidal bench mark.
VICINITY MAP
Clearly identify the entire work site.
Show the course of the river.
Identify the structures crossing waterways within ½ mile of the proposed
Show location of any public park, recreation area, wildlife or waterfowl refuge or
structure.
any historic site in the vicinity.
PLAN VIEW
Show the existing shorelines.
Show the ebb and flood in tidal waters and the direction of flow in non-tidal
Show the mean high and low waterlines if the proposed activity is in tidal areas.
Show an existing bridge, if any is to be replaced, and whether or not it is to be
If the bridge will have a draw, show the draw in the open and closed positions.
Show the principal dimensions of structure from grade to grade. Show length,
Show location of dredging, excavation, fill or rap-rip. Give the approximate
rivers. Show any unusual current patterns if applicable.
Show the ordinary high water line and ordinary low water line if the proposed
activity is in a lake, river or stream.
removed.
width, etc. Show location and dimensions of sidewalks, railings, pipelines, etc.
number of cubic yards and type of material.
Identify and show the location of any fenders, dolphins, piles, cables, etc.
existing or to be constructed in the waterway. Identify the type of material to be
utilized.
Show the limits of maintained navigational channel, if applicable.
Show the axis of channel.
Show the horizontal clearances that are normal to the axis of the channel.
Show the water depth at mean low or ordinary low water at various locations in
the channel, under, upstream and downstream of the bridge.
ELEVATION VIEW
Show the mean high and mean low water elevations in tidal areas. Show
ordinary high and low water in non-tidal areas.
Show the horizontal clearances that are normal to the axis of the channel.
Show the vertical clearances above the mean high or ordinary high water line.
Vertical clearances should be shown at the waterward face of each pier and at
the center the of navigational channel.
Show the proposed and existing contour of the waterway bottom.
Show the 100 year flood height and flood of record.
SECTION VIEW
Include the location of sidewalks, fishing platforms, railings, pipelines, fenders,
rip-rap, etc.
FENDERS (If Applicable)
Show fenders in the plan and elevation views including detail of attachment to
the pier, countersunk bolts, and the relationship to mean high and low
waterlines (on the elevation view).
TITLE BLOCKS
Show the following items in the title blocks located in the bottom right-hand corner:
Applicant, Agent, and Owner
North Arrow
Waterway Name
Mile Point of Bridge Location (in Miles and Metric Equivalent)
City, County, and State
Date of Plans
Sheet Number of Total Number of Sheets in Set
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