Current through Register No. 13, March 27, 2025
To obtain a PBN, the applicant shall complete and submit
to the department the Form NHDES-W-06-27, "Wetlands Permit-By-Notification", as
amended September 2023:
(a) The name,
mailing address, email address, and daytime telephone number including area
code for the applicant, owner if other than the applicant, and the
agent;
(b) Information on the
proposed project location, including:
(1) The
location of proposed project by street address, tax map and lot number, and
latitude and longitude as decimal degrees to 5 decimal places
(D.ddddd);
(2) A copy of the town
tax map showing the location of the proposed project in relation to
abutters;
(3) A copy of the
appropriate US geological survey map with the property and project
located;
(4) Name of water body,
wetland, or other jurisdictional area where work is proposed;
(5) Original or digital photos, clearly
showing the area to be impacted, mounted no more than 2 per sheet, on 8.5
inches by 11 inches paper and annotated to explain impact; and
(6) The results and identification number of
the investigations required by
Env-Wt
306.05;
(c) Information on the proposed project,
including:
(1) Identification of the
applicable minimum project provision in Env-Wt 500, Env-Wt 600, or Env-Wt 900,
as applicable, and any required project-specific information;
(2) A description of the project, including a
list of the work items to be performed and detailed dimensions of the size of
the impacts in jurisdictional areas;
(3) Identification of the type of landform to
be affected, including the type of wetland and type of soils;
(4) An accurate drawing with dimensions
clearly shown to document existing site conditions and to show the location of
the property;
(5) An accurate
drawing to show the impact of the proposed activity on jurisdictional areas,
including the following:
a. An overview of the
property and proposed impact areas in relation to property lines;
b. The scale, if any, used on the
plan;
c. If the drawing is not to
scale, the dimensions of all existing and proposed structures and all other
relevant features necessary to clearly define the project;
d. A labeled north-pointing arrow to indicate
orientation;
e. A legend that
clearly indicates all symbols, line types, and shading used on the
plan;
f. The location of
jurisdictional areas delineated in accordance with Env-Wt 400;
g. Proposed sequence of construction
including pre-construction through post-construction activities and the
relative timing and progression of all work;
h. The location and type of siltation and
turbidity controls indicated graphically and labeled, or annotated as
necessary; and
i. For any project
using a temporary coffer dam and for any repair of a tier 3 stream crossing,
the date, signature, and seal of the licensed professional engineer who
prepared or had responsibility for the plan(s);
(6) The number of linear feet of shoreline
frontage for projects located on water bodies;
(7) The linear distance of the project from
abutting property boundaries;
(8)
Any additional information required by the applicable section in Env-Wt 500,
Env-Wt 600, or Env-Wt 900; and
(9)
The plan date, latest revision date, and preparer's name;
(d) A signed statement by the applicant
certifying, in addition to the certifications specified in
Env-Wt
311.11, that:
(1)
The proposed project meets the conditions and limits of Env-Wt 307 and the
applicable minimum impact project rule;
(2) If the project is to repair or replace a
docking structure, the docking structure is an existing legal
structure;
(3) The proposal is the
alternative with the least adverse impact to jurisdictional areas, as required
by Env-Wt
313.03(a); and
(4) The applicant is aware of the limits of
the PBN and understands and will comply with all conditions in the PBN and all
applicable conditions in Env-Wt 307;
(e) The application fee for minimum impact
projects as required by
RSA
482-A:3, I;
(f) A statement signed by the town or city
clerk of the municipality in which the property is located or, if the property
is located in more than one municipality, by the city or town clerk of each
such municipality, certifying that the municipality has received 4 copies of
the application including all attachments;
(g) A signed statement by the county
conservation district or certified wetland scientist, if required by the
appropriate minimum impact project rule, certifying compliance with all
conditions of that rule;
(h) In
addition to the information required in (a) through (g) above, the applicant
may submit a signed statement from the conservation commission or, if there is
no conservation commission, the local governing body, certifying that the
municipality waives its right to intervene on the project, unless the PBN is
for one of the following project types in which case no review or signed
statement is necessary to qualify for review under
Env-Wt
309.08(a)(1):
(1) Replenishment of an existing legal beach
that complies with Env-Wt
511.07(a);
(2) Repair or replacement of an existing
legal deck or patio that complies with
Env-Wt
511.08;
(3) Repair or replacement of an existing
legal docking structure that complies with
Env-Wt
513.25;
(4) Repair or replacement of an existing
legal retaining wall that complies with
Env-Wt
514.07(a)(3);
(5) Maintenance or repair of an existing
legal boathouse that complies with
Env-Wt
515.07;
(6) Maintenance of an existing legal tidal
docking structure that complies with
Env-Wt
606.17(b);
(7) Repair of an existing legal tier 1 or
tier 2 stream crossing that complies with
Env-Wt
903.01(e)(2);
(8) Repair of an existing legal tier 3 stream
crossing that complies with
Env-Wt
903.01(e)(3); and
(9) Replacement of an existing legal tier 1
stream crossing that complies with
Env-Wt
903.01(e)(4); and
(i) A signed statement from the
LAC, if the project is a routine roadway maintenance activity within LAC
jurisdiction, certifying that the LAC waives its right to intervene on the
project.