U.S. ARMY CORPS OF ENGINEERS

U.S. ARMY CORPS OF ENGINEERS APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT 33 CFR 325. The proponent agency is CECW-CO-R. Form APPrOxed - OMB No. 0710-0003 Expires: 30-SEPTEMBER-2015 Public reporting for this collection of information is estimated to average 11 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completi-ig and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect 01 the collection of information, including suggestions for reducing thd burden, to Department of Defense, Washington Headquarters. Executive Services and Communications Directorate, Information Management Division and to the Office of Management and Budget, Paperwork Reduction Project (0710-0003). Respondents should be aware that nohvithstandiog any other provision of law, no person shoe be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to either of those addresses. Completed applications must be submitted to the District Engineer having jurisdiction over the location of the proposed activity. PRIVACY ACT STATEMENT Authorities: Rivers and Harbors Act. Section 10. 33 USC 403; Clean Water Act, Section 404. 33 USC 1344; Marine Protection. Research, and Sanctuaries Act, Section 103.33 USC 1413: Regulatory Programs of the Corps of Engineers; Final Rule 33 CFR 320-332. Principal Purpose: Information provided on this form will be used in evaluating the application for a permit. Routine Uses: The information may be shared with the Department of Justice and other federal. state, and local goverment agencies, and the public and may be made avafable as part of a public notice as required by Federal law. Submission of requested information is voluntary, however, if information is not provided the permit application cannot be evaluated nor can a permit be issued. One set of original drawings or good reproducible copies which show the location and character of the proposed activity must be attached to this application (see sample drawings and/or instructions) and be submitted to the District Engineer having jurisdiction over the location of the proposed activity. An application that is not completed in full mil be returned. (ITEMS 1 THRU 4 TO BE FILLED BY THE CORPS) 1 . APPLICATION NO. 2. FIELD OFFICE CODE 3 ()ATE RECEIVED 4. DATE APPLICATION COMPLETE (ITEMS BELOW TO BE FILLED BY APPLICANT) 5. APPLICANTS NAME Fast -Erika Middle -A. Last - Kellerhals Company - Great St. Jim, LLC E-mail Address -ekellerhals®kcIlfer.com 8. AUTHORIZED AGENT'S NAME AND TITLE (agent is not required) First -Amy Middle -Claire Last - Dempsey Company - Bioimpact, Inc. E-mail Address - [email protected] E. APPLICANTS ADDRESS: Address- 9053 Estate Thomas Suite 101 City- St. Thomas State- VI Z*0 - 0802 Country -USA 9. AGENTS ADDRESS: Address- P.O. Box 132, Kingshill City- St. Croix State- VI Zip - 0085 Country -USA 7. APPLICANTS PHONE NOs. w/AREA CODE a. Residence b. Business c. Fax (340) 779-2564 (888) 316-9269 10. AGENTS PHONE NOs. wIAREA CODE a. Residence b. Business c. Fax 340 773 5881 340 690-8445 340 718-3800 STATEMENT OF AUTHORIZATION '1 I hnoy authorize, Claire Oem act in my behalf as my agent m the processing of this application CriPili R and to furnish, upon request, suppcmental information in supped this application. S F APPL CANT UATE NAME, LOCATION, AND DESCRIPTION OF PROJECT OR ACTIVITY 12. PROJECT NAME OR TITLE (see instructions) Access Dock, Dock/Barge Ramp and Temporary Barge Ramp 13. NAME OF WATERBODY, IF KNOWN (if applicable) Pillsbury Sound - Great St. James Northern Bay 14. PROJECT STREET ADDRESS (if applicable) Address Parcel A City - State- Zip- 15. LOCATION OF PROJECT Latitude: 44 18° 18.745' Longitude: WV 64'49.589 16. OTHER LOCATION DESCRIPTIONS, IF KNOWN (see instructions) State Tax Parcel ID 106801010100 Municipality Section - Great St. James Township • Range - ENG FORM 4345, DEC 2014 PREVIOUS EOMONS ARE OBSOLETE. Page 1 of 3 EFTA00793341 I7- DIRECTIONS TO THE SITE From Red I look, St. Thomas proceed south in Pillsbury Sound to Great St. James, the dock is located in the northeast bay. ta. Nature of Activity (Description of project, include all features) Great St. Jim, LLC is seeking to construct two docks. one of which is a combination dock/ barge landing, and a temporary barge landing to provide access to Great St. James Island. There is currently a small pile-supported dock located within Shallow Bay on the north side of the island. The toy is very shallow and vessels accessing the dock have damaged the shallow seagrass beds within the bay. At one time, there had been a concrete bulkhead at the shoreline with a small floating dock. The previous owner submitted an application for the existing dock which was approved by DPNR's Division of Coastal Zone Management. but was not approved by the U.S. Army Corps of Engineers due to objections by National Marine Fisheries because of the shallowness of the bay. The dock was constructed by the previous owner despite not receiving the federal permit and notices were issued by the USACE requesting the removal of' the unpermitted structure. The dock however was never removed. The applicant, understands the issues with the existing dock and is proposing to remove the dock as soon as another dock is constructed and usable. (cont.) 19. Project Purpose (Describe the reason or purpose of the project. see instructions) The purpose of this application is to provide access to the island of Great St. James. Great St. Jim. LLC is proposing to construct a temporary barge landing to be used during the construction of the other docks, an access dock on the western side of the island to be used for worker and guest access to the island, and a combination barge landing/dock on the southeast side of the island on the point closest to I.ittle St. James. The existing dock in Shallow Bay will be removed as soon as one of the docks is functional. USE BLOCKS 20-23 IF DREDGED AND/OR FILL MATERIAL IS TO BE DISCHARGED 20. Reason(s) for Discharge No discharge is proposed. 21 Type(s) of Material Being Discharged and the Amount of Each Type in Cubic Yards: Type Type Type Amount in Cubic Yards Amount in Cubic Yards Amount in Cubic Yards O 0 0 22. Surface Area in Acres of wetlands or Other Waters Filled (see instructions) Acres 0 a Linear Feet 0 23. Description of Avoidance, Minimization, and Compensation (see instructions) fhe docks have been located so that they avoid all ESA listed corals and minimize the size of the structures as much as possible while still achieving sufficient depth to prevent bottom disturbance. All corals within the dock footprints and in the area of impact will be transplanted prior to construction. A reef buildings structures is proposed as part of the dock structure to compensate for unavoidable Impacts. ENG FORM 4345, DEC 2014 Page 2 of 3 EFTA00793342 24. Is Any Portion of the Work Already Complete? Ekes No IF YES, DESCRIBE THE COMPLETED WORK The previous owner built the existing dock without USACE permits. The applicant will remove the dock as soon as the a new dock is permitted and constructed. A emergency ramp is Christmas Cove. The ramp was built after hurricane Irma to bring emergency supplies to the island for employees and their families who had lost their homes and for people staying on the island. The applicant would like to keep this ramp until the proposed ramp is permitted and constructed 25. Addresses of Adjoining Property Owners, Lessees, Etc., Whose Progeny Adjoins the Waterbody (if MOOS run can be Wired he , e . onset...xi • ivogionenia Imu a. Address- Great St. Jim. LI.C, do Erika A. Kellerhals, 9053 Estate Thomas Suite 101 City- St. Thomas State- Vi BP - 00802 b. Address- City - State • Zip - c. Address- City • State - ZIP • d. Address- City - State - Zip • e. Address- City • State • La • 26. List of Other Certificates or Approvals/Denials received from other Federal, State, or Local Agencies for Work Described in This Application. AGENCY TYPE APPROVAL' IDENTIFICATION DATE APPLIED DATE APPROVED DATE DENIED NUMBER DPNR/CZM Major Water concurrent DPNR/DEP Water Quality Cert. concurrent • Would include but is not restricted to zoning. building, and flood plain permits 27. Application is hereby made for permit or permits to authorize the work described in this application. I certify that this inkmkstion In this application is complet untie, certify that I possess the authority to undertake the work described herein or am acting as the duly authorized agent of the apNica O:17i iille SIGNATU APPLICAN DATE SIGNATURE OF AGENT DATE The Application must be signed by the person who desires to undertake the proposed activity (applicant) or it may be signed by a duly authorized agent if the statement in block 11 has been filled out and signed. 18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, conceals, or covers up any trick, scheme, or disguises a material fact or makes any false, fictitious or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or fraudulent statements or entry, shall be fined not more than $10,000 or imprisoned not more than five years Or both. ENG FORM 4345, DEC 2011 Page 3 of 3 EFTA00793343 EFTA00793344