INSTRUCTIONS FOR THE PREPARING AND FILING OF APPLICATIONS WITH THE SRCC. APPLICATION CHECKLIST AND DEADLINE FOR FILING Sewage Disposal Plan (HHE-200)*

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SACO RIVER CORRIDOR COMMISSION P.O. BOX 283, 81 MAPLE STREET ~ CORNISH, MAINE 04020-0283 TELEPHONE (207) 625-8123 ~ FAX (207) 625-7050 ~ E-MAIL: srcc@srcc-maine.org VISIT US ON THE WEB AT www.srcc-maine.org INSTRUCTIONS FOR THE PREPARING AND FILING OF APPLICATIONS WITH THE SRCC Application* APPLICATION CHECKLIST AND DEADLINE FOR FILING Sewage Disposal Plan (HHE-200)* Detailed Site Plan, Must Be To Scale* Applicant s Notice of Intent to File an Application* Application Fee Deed or Purchase and Sale Agreement Certificates of Mailing received at Post Office Hardship Variance Form (See Note Below)* Other (please submit any other information that will assist the SRCC in considering your application such as house plans, elevation views, contour maps, photographs, etc.)* * These items must be submitted in duplicate. An incomplete application (one that does not include all of the items required from the box above) may result in delays! If you need any assistance in preparing these forms, please contact Commission Staff. All of the above described items must be received by the Commission Office no later than 4:00 p.m. on the first Wednesday of the month in order to be considered for that month s Commission Meeting. There will be no exceptions to this Rule. Projects that require a hardship variance, have a great public concern, or have any complications may be considered at a later month. Any faxed submissions must be followed by a hard copy in the mail. Note: Hardship Variances are necessary if you are requesting the relaxation of a standard due to limitations of the site which would make it impractical or unreasonable to expect you to adhere to the particular standard. APPLICATION FEE SCHEDULE Please submit the one fee based on your principal activity. Checks or money orders should be made payable to the Saco River Corridor Commission (SRCC). All application fees are non-refundable. 1. Single Family Residence with or without Garage a. No Hardship Variance Required $ 300.00 b. Hardship Variance Required $ 450.00 2. Accessory Structure or Addition a. No Hardship Variance Required Less than 100 square feet $ 100.00 More than 100 square feet $ 150.00 b. Hardship Variance Required $ 150.00 3. New or Replacement Septic System $ 85.00 4. Excavating or Filling Less than 50 cubic yards $ 125.00 More than 50 cubic yards $ 200.00 5. Establishment of New Use - no new construction $ 150.00 6. Commercial Development Less than 5,000 sq. ft. $ 350.00 5000 sq. ft. to 10,000 sq. ft. $ 500.00 Greater than 10,000 sq. ft. $ 750.00 7. All Other $ 450.00 8. Amendment to Previous Permit Approval $ 100.00 9. Reconsideration of Previously Submitted Application $ 125.00 10. Time Extension Amendment $ 50.00 11. After the Fact Permits for any category are double and do not preclude other financial penalties and/or conditional requirements.

NOTIFICATION REQUIREMENTS The Applicant s Notice of Intent to File an Application form, which has been provided to you, must be completed, photocopied, and then mailed by use of a Certificate of Mailing (not to be confused with certified mail which is more costly), available at a U.S. Post Office, to the following people by the application deadline: 1. All abutters; 2. All property owners within 500 feet of the proposed use (250 feet in Lake Arrowhead Estates and in Camp Ellis, Saco); 3. The local municipal officers (Board of Selectmen or Mayor); and 4. The local planning board. Each Certificate of Mailing received for the above listed persons must be submitted with the application. Another acceptable option instead of or in combination with the Certificates of Mailings is to have those persons listed above sign the form and date their signature. The form located on the back of the intent to file must also be filled out and submitted with this application. If all required parties are not notified correctly, the application must be delayed. SITE PLAN An example site plan and tips for creating a sufficient plan have been provided for you with this application form. Although we do not require a professional to draw up your plan we do ask that you take care in the preparation of your site plan and follow all of the guidelines that have been suggested to you. HARDSHIP VARIANCE If you are seeking a hardship variance, the enclosed hardship variance form must filled out and read to the full Commission during a public hearing that will be scheduled for your project. Please use this form as a means for organizing your thoughts for presentation to the Commission. We strongly encourage you to discuss your proposal for a hardship variance with the Executive Director as soon as possible. If you are unsure whether you need to apply for a hardship variance please contact Commission Staff. SRCC STAFF SITE VISITS It may be necessary for Commission Staff to visit your site in order to take photographs and/or take on-site measurements. Your lot must be clearly marked from the road with either the lot number or with the applicant s name. In addition, you must place stakes or other prominent markers showing the location of the proposed structure(s) on the lot. It is not necessary for you to be present during our site visit. Please contact the office as soon as you file your application to make arrangements if you would prefer to be present during our site visit. HOW TO CONTACT US DO NOT hesitate to contact the office if you have any questions when filling our this application form. Regulatory Staff can be reached by telephone (207-625-8123), fax (207-625-7050) or e-mail (srcc@srccmaine.org). We also have a web site located at www.srcc-maine.org which has printable versions of our entire application form, sample site plan, and all regulations and performance standards of the Commission. Our current office hours are Monday through Thursday from 8:00 a.m. to 4:00 p.m. We thank you for your continued cooperation with this agency.

Communities Working Together To Protect Our Rivers APPLICATION FOR A SRCC PERMIT ~ SUBMIT THIS FORM AND REQUIRED ATTACHMENTS AT P.O. BOX 283, 81 MAPLE STREET ~ CORNISH, MAINE 04020-0283 TELEPHONE (207) 625-8123 ~ FAX (207) 625-7050 ~ E-MAIL: srcc@srcc-maine.org A P P L I C A N T A N D A G E N T I N F O R M A T I O N 1. Name of Applicant 4. Name of Agent (if applicable) 2. Applicant s 5. Agent s Mailing Address 3. Applicant s Daytime Telephone # and email address 7. Statement of Authorization Mailing Address 6. Agent s Daytime Telephone # and email address I hereby authorize the above named person to act in my behalf as my agent in the procession of this application. Signature of Applicant: P R O J E C T L O C A T I O N 8. Location of Project 9. Municipality 10. Detailed Driving Directions to Site Attach map if necessary L O T I N F O R M A T I O N 11. Size of Lot(s) square feet, or acres 12. Lot Frontage feet on the water on the side closest to and most nearly parallel to the water Saco River Ossipee River Little Ossipee River Lake Arrowhead Balch Lake 13. Slope Conditions in Flat (0-3% slope) Rolling (3-8% slope) Hilly (8-15% slope) Steep (15+% slope) Area of Construction 14. Describe any Wetland areas on the lot 15. Right, Title or Interest (must be attached) Own Lease Purchase Option Under Contract Other (explain) Name and Address of Name and Address: Current Owner if Different from Applicant 16. Deed Reference Book # Page # 17. Town Map and Lot Numbers Numbers 18. Date of Purchase Agreement Map # Lot # 19. Date of Transfer of Title 20. Has this lot, at any time on or after March 19, 1974, been in the same ownership as abutting property? 21. Has a previous permit been issued by the SRCC for activities on this property? If yes, to whom was the permit issued? Yes No Yes No Name: Permit #

22. Detailed Project Description P R O J E C T D E S C R I P T I O N 23. Statement of Necessity S E W A G E D I S P O S A L A N D W A T E R S U P P L Y 24. Sewage Disposal Attach complete soil test report (HHE-200) Septic Tank/Leach Field Municipal Sewer System Other (explain) 25. Proposed Water Supply Drilled Well Dug Well Municipal Water System Other/Existing B U I L D I N G S P E C I F I C A T I O N S (FOR CONSTRUCTION OF A NEW BUILDING) 26. Nature of New Construction (check all that apply) Single Family Residence w/ Attached Garage Detached Garage Other Accessory Structures Other If the dimensions are irregular in shape, provide us with the overall dimensions for questions 27 and 29. Please be sure the submitted site plan has all dimensions indicated accuratly. 27. Foundation Dimensions Width feet Length feet 28. Type of Foundation Slab Full Concrete Posts Other (explain) 29. Outside Dimensions Width feet Length feet Height feet 30. Setback Measurements From the Road is feet From the Closest Point of Water is feet From the Nearest Structure on Abutting Lots is feet Please use the space below to answer questions 27 through 30 for any accessory structures (i.e. detached garage, tool shed, fences) you may also be planning to build on the lot. Be sure these structures are depicted on the submitted site plan.

B U I L D I N G S P E C I F I C A T I O N S (FOR EXPANSION OF AN EXISTING BUILDING) 31. Nature of Existing Building Single Family Residence Garage Accessory Structure Other (explain) 32. Nature of Expansion Extra Living Space (explain) Bedroom Bathroom Garage Porch/Deck Basement If the dimensions are irregular in shape, provide us with the overall dimensions for questions 28 and 29. Please be sure the submitted site plan has all dimensions indicated accuratly. 33. Dimensions of Existing Width feet Length feet Height feet Building 34. Dimensions of Expansion Width feet Length feet Height feet 35. Type of Foundation for EXISTING: Slab Full Concrete Posts Other (explain) Existing Building and Proposed Expansion EXPANSION: Slab Full Concrete Posts Other (explain) 36. Setbacks of Existing Building From the Road is feet From the Closest Point of Water is feet 37. Setbacks of Proposed Expansion From the Nearest Structure on Abutting Lots is feet From the Road is feet From the Closest Point of Water is feet From the Nearest Structure on Abutting Lots is feet V E G E T A T I O N 38. Describe the existing vegetation conditions in all areas of proposed development including trees. C O N D I T I O N S 39. Describe vegetation to be removed in all areas of proposed development including trees. 40. Describe proposed landscaping and soil stabilization to occur after proposed development has been completed. D O C K S A N D P A T H W A Y S T O T H E W A T E R F R O N T 41. Do you plan to install a seasonal dock on your property? Yes No If Yes, explain in detail: 42. Do you plan to create a meandering pathway leading to your waterfront? If so, do you plan the construction of any stairs within your pathway? Yes If, Yes, explain in detail: No

S I G N A T U R E P A G E By signing this application, I the aforesaid applicant, or agent of the applicant, certify that a) I have read and completely understand the application, b) the information contained in this application and it s supplements are true and correct, and c) that I have served notice of my intent to file this application on all parties identified in the Instructions for Preparing and Filing Applications. In addition, I authorize the SRCC, it s staff, and other representatives to inspect the site in question at any reasonable time. SIGNATURE OF APPLICANT OR AGENT: DATE: PRINTED NAME OF APPLICANT OR AGENT: NOTE: Additional information may be required in some instances. Any person who willfully or knowingly falsifies any statement to the Commission shall be punished by the revocation of any permit, certificate of compliance, or variance granted by the Commission in reliance on such statement and by a fine of up to but not more than $1,000 according to Title 38 M.R.S.A. Section 967. FOR SRCC USE APPLICATION # FEE CHECK # DATE RECEIVED

SACO RIVER CORRIDOR COMMISSION P.O. BOX 283, 81 MAPLE STREET ~ CORNISH, MAINE 04020-0283 TELEPHONE (207) 625-8123 ~ FAX (207) 625-7050 ~ E-MAIL: srcc@srcc-maine.org APPLICANT S NOTICE OF INTENT TO FILE AN APPLICATION Directions to the Recipient - Please Read: This form as been mailed to you in order to make you aware that the applicant stated below has filed, or will soon file, an application with this agency for the project described below. All applicants are required to mail this notice to all abutters and property owners within 500 feet of the project described below. No action is required on your part unless you would like to offer your comments or concerns to this agency. Typically, our applications are decided upon during a Commission Meeting held on the fourth Wednesday of each month. The applicant was required to have this form postmarked to you by the second Wednesday of the month prior to the meeting date. Please submit any written comments, or a written request for a public hearing to Commission Staff by 4:00 p.m. on the date of the Commission Meeting. Any oral comments or an oral request for a public hearing may be offered at the discretion of the Chairperson at the scheduled Commission Meeting. Any requests a public hearing surrounding a particular project must be for a reason that is directly tied to the standards within the Saco River Corridor Act (Title 38 M.R.S.A. Section 951 et.seq.) PLEASE TAKE NOTICE THAT WHOSE Name of Applicant MAILING ADDRESS IS INTENDS Applicant s Mailing Address TO FILE AN APPLICATION WITH THE SACO RIVER CORRIDOR COMMISSION UNDER THE SACO RIVER CORRIDOR ACT (TITLE 38 M.R.S.A. SECTION 951 ET.SEQ.) TO UNDERTAKE THE FOLLOWING ACTIVITIES: Detailed Project Description WITHIN THE CORRIDOR ON MUNICIPAL LOT # (TAX MAP # ) LOCATED Lot # Map # ON IN THE MUNICIPALITY OF, MAINE. Physical Location (Road/Street) Municipality the property is located in THE APPLICATION WILL BE FILED WITH THE COMMISSION ON THE DAY OF, IN THE YEAR. Day the application should be received at the office, BUT no later than the application deadline THIS APPLICATION WILL BE AVAILABLE FOR PUBLIC INSPECTION AT THE COMMISSION S OFFICE AT 81 MAPLE STREET IN CORNISH, MAINE AND AT THE MUNICIPAL OFFICES IN, MAINE. Municipality the property is located in WRITTEN COMMENTS OR ANY REQUESTS FOR A PUBLIC HEARING ON THE APPLICATION MUST BE RECEIVED BY THE COMMISSION AT THE ADDRESS GIVEN ABOVE WITHIN FOURTEEN (14) DAYS OF THE FILING OF THE APPLICATION IN THE COMMISSION S OFFICE.

APPLICANT S NOTICE OF INTENT TO FILE AN APPLICATION CONTINUED Use this space to list all abutters and property owners within 500 feet of the proposed development who received the Applicant s Notice of Intent to File an Application from you. Please photocopy and attached additional forms if more space is needed. This list must be a complete and printed legibly. YOU MUST ATTACH A COPY OF THE MUNICIPAL TAX MAP(S) WITH THE LOTS HIGHLIGHTED WHICH REPRESENTS EACH LANDOWNER WHO RECEIVED NOTIFICATION OF DEVELOPMENT FROM YOU. THE LOTS INDICATED ON THE MUNICIPAL TAX MAP MUST CORRESPOND WITH THE FOLLOWING LIST. Map & Lot Number 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 21. 21. 22. 23. 24 25. Landowner s Name Landowner s Mailing Address