EPC Logo
Environmental Protection Commission of Hillsborough County
Roger P. Stewart Center
3629 Queen Palm Drive · Tampa, FL 33619
Ph: (813) 627-2600 · Fax: (813) 627-2630
www.epchc.org
Application for a
Delegated Tampa Port Authority Minor Work Permit - MWP09

Pursuant to Chapter 95-488, Laws of Florida, and Interlocal Agreement between the EPC and the Tampa Port Autthority, and person desiring to dredge, fill, build or moor any structure on submerged lands with the Port District must apply to the EPC, if the site falls within the delegated areas. For full guidelines, see the EPC Minor Work Permit Guidelines.
 
Any required fee must be submitted with this application. Incomplete applications, including the fee, will not be processed until all missing information is provided.
 
Please direct any questions you may have regarding Minor Work permitting to EPC Wetlands Department directly at (813) 627-2600.

* Indicates a required field.

CHECK ONE:
NEW
PERMIT REVISION
AFTER-THE-FACT

SECTION I


1.  Brief Minor Work Project Description


2.  Property Owner Information


3.  Authorized Agent Information (if applicable)
Are you using an agent?

SECTION II


1.  Location of Proposed Project
Parcel ID: *
 Required
Section
Township
Range


2.  Proposed Use
Proposed: *


3.  Owner of Submerged Lands


4.  Previous Tampa Port Authority Permits Issued at This Location
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5.  Project Description
Check to confirm that your project is not located in critical habitat for smalltooth sawfish or gulf sturgeon, as applicable. *
Check to confirm that if your project is located in waters accessible to manatees, the project shall not affect or will not directly or indirectly likely adversely affect manatees, as applicable. *
A.  Structures
1)  Dock, Observation Deck, Pier, or Elevated Boardwalk (check applicable boxes)
 (if applicable)
Length of Shoreline (in linear feet)
Number of Proposed Docks
Number of Boat Slips / Lifts
Length from OHW/MHW to Waterward Edge of Structure (in feet)
Width of Structure (in feet)
Mooring Water Depth at O/MLW (in feet)
Existing Structure Area (in square feet)
Proposed Structure Area (in square feet)
Overall Area of Facility (in square feet)
2)  Seawalls, Rip-Rap, Revetments, or Other Shoreline Stabilization (check applicable boxes)
 (if applicable)
Length of Shoreline at Site (in linear feet)
Length of Work Proposed Along Shoreline (in linear feet)
Seawall Vertical Height (in feet)
Rip-Rap Slope - Horizontal Distance (in feet)
Rip-Rap Slope - Vertical Height (in feet)
Type of Material
Dredged Volume (in cubic feet)
Filled Volume (in cubic feet)
3)  Other Type of Structure
B.  Dredging / Excavation
Refer to the Checklist for Dredge Projects for applicable information.
1)  Dimensions of Areas to be Dredged / Excavated
 (required)
Length (in feet)
Width (in feet)
Total Area (in square feet)
Depth - Existing
Depth - Proposed
Volume - Above OHW/MHW
Volume - Below OHW/MHW
Volume - Total
Area - Above OHW/MHW
Area - Below OHW/MHW
Area - Total
3)  Storage of Material

Please Check
C.  Filling
Refer to the Checklist for Fill Projects for material sampling requirements and other applicable information.
1)  Volume
 (required)
Volume - Above OHW/MHW
Volume - Below OHW/MHW
Volume - Total (in cubic yards)
2)  Area
 (required)
Area - Above OHW/MHW
Area - Below OHW/MHW
Area - Total (in square feet)
3)  Containment
5)  Source of Material


6.  Work Schedule
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7.  Remarks / Comments for Project


8.  Public Interest Statement
Accordingly, in the Comment Box provided below, describe how your proposed project is not contrary to the public interest based on the criteria outlined in Section II. D.1. of the Tampa Port Authority Submerged Lands Management Rules.
a.  The decision to authorize the use of Jurisdictional Lands requires a determination that such use is not contrary to the public interest, except for lands within Aquatic Resource Protection Areas, in which case it must be determined that the use is in the public interest. In all cases it will be in the responsibility of the applicant to provide evidence as to the public interest impact of the proposed activity or use.
 
b.  The public interest determination requires an evaluation of the probable impacts of the proposed activity on Jurisdictional Lands and the associate water body. All direct and indirect impacts related to the proposed activity as well as the cumulative effects of those impacts shall be taken into consideration. Relevant factors to be considered include: conservation, general environmental and natural resource concerns, wetlands values, cultural values, fish and wildlife values, flood hazards, floodplain values, land use, navigation, shore erosion and accretion, recreation, water supply and conservation, water quality, aesthetics, economics, public health and safety, relative extent of the public need for the proposed use or activity, reasonable alternative locations and methods to accomplish the objective of the proposed use or activity, potential detrimental effects on the public uses to which the area is otherwise suited, the effect on cultural, scenic and recreational values, and the needs and welfare of the people.

SECTION III


1.  Adjacent Property Owners
Project site adjacent riparian property owners:

SECTION IV


TERMS OF AGREEMENT
APPLICANT ACKNOWLEDGEMENT *
CERTIFICATION OF SUFFICIENT REAL PROPERTY INTEREST AND AUTHORIZATION FOR STAFF TO ACCESS TO THE PROPERTY: *
DESIGNATION OF AUTHORIZED AGENT: *
By signing this application form, I am applying for the permit(s), according to the information filed with this application. I am familiar with the information contained in this application and represent that such information is true, complete and accurate. I understand this is an application and not a permit, and that work prior to approval may be a violation. I understand that this application and any permit issued thereto, does not relieve of any obligation for obtaining any other required federal, state, water management district or local permit prior to commencement of activities. I agree to operate and maintain the proposed activity in compliance with permits and laws, unless the EPC authorizes transfer of the permit to a different responsible entity. I understand that my application will not be processed if there is any missing, insufficient, or invalid information or insufficient fees. I understand I may have to provide any additional information/data that may be necessary to provide reasonable assurance of evidence to show that the proposed project will comply with applicable water quality standards or other environmental standards/laws. I agree that upon written concurrence, the EPC may make changes to the application based on revised drawings and/or additional information provided by agent or applicant. I further agree EPC can unilaterally change non-substantive typographically errors. I understand that knowingly making any false statement or representation in this application is a violation of EPC Act and rules, and may result in among other things, revocation of the permit or denial of the application. *
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SECTION V