POND CONSTRUCTION PLAN

Landowner _________________________________ Phone ___________________________ Address ____________________________________ City ______________ Zip ___________________ Pond site location _______________________________________ Township __________________ ______________________________________________________

Application complete/fee paid By: Date

Site inspection complete By: Date

Soils investigation complete By: Date

Survey complete By: Date

Letter/plan mailed to landowner w/copy to zoning inspector

By: Date

Construction check complete By: Date

Send letter of deficiency (if needed) w/copy to zoning insp.

By: Date

Final report letter to landowner w/copy to zoning inspector

By: Date

$250.00 refund issued By: Date

Plan complete By: Date