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APPUCATIO <br /> N OR SUBDIVISION <br /> [N E2UN GOUW Y COMMUNITY DEVELOPMENT DEPARTMENT <br /> 0000*0 wW wow VA460 to flooding 4inalude flood depths and Hood panel map number): <br /> flnmincrp see Panal #165 <br /> Ir otrEr�t daph of the ground wow and depth to potable water: �1Q <br /> Deieiibe any eaddit drainage courees or eroded We"on.or now the prajad oft(e.g..rivers,creeks or drainage ditches): <br /> Ehtsgri4e the$We top try(e.g.herd farms,slopes,eta.): <br /> -`�.0119E3� <br /> { <br /> 0000tlbe sir Culhsral lsed that will be lost as'*mu#of da project(type of w*M son,quaky Of soil,etc.). <br /> - - <br /> -Oftafto any wildlife.habW on-eke and apo*w that we of mW be present: <br /> 7 . <br /> ' F++S <br /> tk <br /> by yI;w and aclaot:' <br /> Demme air poHv <br /> *Ad stay result from the project(e.g.zondme0on raMod dust,vehicle trips per day,fire places,incinerators, <br /> tis eagl'k f of hWArkW or Ical']ntered on-ails(e.q.cemeteries or structures): <br /> any ones or olReifs source.of,noiM or vibra on �raeway nolee;hemy egtripmsnt,etc.): <br /> s€� <br /> or ►"am" 9. tatligliii1ip,cr rs'lcoliie materials used): <br /> 77i .. . <br /> DaWlim any on-slte or off-site source of odor(e.g.agrlat t nd wastes): <br /> DMoft any displacement d peopfa lAw w*6a Qaueed by the project(e.g.ftwnbers of people,hou**unks): <br /> a c 1 } 1. _ <br /> OEM <br />