Scale: 1 in. = ____ mi.
Use of U.S.G.S. quadrangle
map(s) is recommended.
Complete details with dimensions of
gravel bar and/or debris is required.
The removed gravel or deposit material
must be disposed of outside the 100-year
OR GRAVEL BAR REMOVAL
FROM OR ALONG THE
NAME OF STREAM
AT OR NEAR
TOWN, TOWNSHIP & COUNTY