"Submission Checklist for Watercourse Alteration" - Nova Scotia, Canada

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Submission Checklist for Watercourse Alteration
Environment
This checklist must accompany every application for a watercourse alteration approval. Complete Section A
for all applications, Section B must be completed for flowing watercourses (such as rivers, streams, etc). Section C
is specific to erosion protection. If you require assistance with completing this form or preparing the information
required in support of the application, please contact your local NSE office to obtain a list of Watercourse
Alteration Certified Individuals. If an item is not provided, the submission will be considered incomplete.
S
A (F
A
)
ECTION
OR ALL
PPLICATIONS
ALL INFORMATION MUST BE PROVIDED
:
Name of watercourse and watercourse it is a tributary to
Community and County name
1:50,000 Topographic map with alteration location marked
1:50,000 Topographic map number with grid reference (easting and northing)
Preconstruction site photos (colour or electronically)
Work plan for in-the-dry installation (water control)
Erosion and sedimentation control plan
Plan and profile drawing of proposed alteration (including dimensions)
Description of channel bottom (ie. rock (size, quantity), muck, etc.)
Plans, drawing and specifications (including whether the alteration will be in accordance with the NS
Watercourse Alterations Standard, latest edition, or a description of an alterative plan)
S
B (I
F
W
) :
ECTION
NCLUDE FOR
LOWING
ATERCOURSES
Watercourse velocity (metres/second)
Watercourse channel width (top of bank to top of bank)
Watercourse channel depth (from top of bank)
Calculations for sizing of structure, including but not limited to watershed area (1:100 yr return event for
permanent structures)
S
C (I
E
P
):
ECTION
NCLUDE FOR
ROSION
ROTECTION
Calculations for erosion protection material sizing
It is an offense under Sections 158 (a) and 158 (b) of the Environment Act to provide false or misleading
information. I certify all of the above required information has been submitted and complies with the
requirements set out in the Environment Act and the Activities Designation Regulations, including design and
construction requirements.
Certified Installer Section (required as of Oct 1, 2016)
Applicant Section
Certified Watercourse Alteration Installer Name (please print)
Applicant Name (please print)
Certified Watercourse Alteration Installer Phone Number
Applicant Signature
Date Signed
Certification Number
Updated October, 2014
Submission Checklist for Watercourse Alteration
Environment
This checklist must accompany every application for a watercourse alteration approval. Complete Section A
for all applications, Section B must be completed for flowing watercourses (such as rivers, streams, etc). Section C
is specific to erosion protection. If you require assistance with completing this form or preparing the information
required in support of the application, please contact your local NSE office to obtain a list of Watercourse
Alteration Certified Individuals. If an item is not provided, the submission will be considered incomplete.
S
A (F
A
)
ECTION
OR ALL
PPLICATIONS
ALL INFORMATION MUST BE PROVIDED
:
Name of watercourse and watercourse it is a tributary to
Community and County name
1:50,000 Topographic map with alteration location marked
1:50,000 Topographic map number with grid reference (easting and northing)
Preconstruction site photos (colour or electronically)
Work plan for in-the-dry installation (water control)
Erosion and sedimentation control plan
Plan and profile drawing of proposed alteration (including dimensions)
Description of channel bottom (ie. rock (size, quantity), muck, etc.)
Plans, drawing and specifications (including whether the alteration will be in accordance with the NS
Watercourse Alterations Standard, latest edition, or a description of an alterative plan)
S
B (I
F
W
) :
ECTION
NCLUDE FOR
LOWING
ATERCOURSES
Watercourse velocity (metres/second)
Watercourse channel width (top of bank to top of bank)
Watercourse channel depth (from top of bank)
Calculations for sizing of structure, including but not limited to watershed area (1:100 yr return event for
permanent structures)
S
C (I
E
P
):
ECTION
NCLUDE FOR
ROSION
ROTECTION
Calculations for erosion protection material sizing
It is an offense under Sections 158 (a) and 158 (b) of the Environment Act to provide false or misleading
information. I certify all of the above required information has been submitted and complies with the
requirements set out in the Environment Act and the Activities Designation Regulations, including design and
construction requirements.
Certified Installer Section (required as of Oct 1, 2016)
Applicant Section
Certified Watercourse Alteration Installer Name (please print)
Applicant Name (please print)
Certified Watercourse Alteration Installer Phone Number
Applicant Signature
Date Signed
Certification Number
Updated October, 2014