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Dock and Shoreline Stabilization Application

  Dock or Shoreline Construction Project Information

Complete the attached Application/Permit Form and submit with the construction plan, type of materials to be used, and design layout to:

Jayne Averitt
WLCD Vice President
940 W Kamleifer Drive
Nineveh, IN  46164
Email:  javeritt848@gmail.com

No shoreline disturbance within four feet of shoreline is allowed during construction.  Only vegetation removal necessary for construction is allowed.  Erosion control fencing or other type of erosion control material is required during construction to avoid sediment washing into the White Lake.  If lake owner’s lot requires excavation, see Prince’s Lake Town Ordinance EROSION AND SEDIMENT CONTROL 152.100§ 152.100 PURPOSE.

·                  No construction is allowed on White Lake, nor shall any permanent structures be located upon White Lake, until said construction and/or structure permit has been approved by the WLCD Board of Directors. Freeholders seeking to construct or place structures upon White Lake shall complete permit application and submit drawings, plans and specifications (including type of material to be used) describing the structure and the construction to be undertaken to the WLCD Board for approval. 
·                  White Lake is owned by the WLCD.  As such, the District imposes rules and regulations concerning construction of docks and any other structure attached to the lake bottom, as well as construction on the shoreline and areas within the White Lake watershed.  No one shall alter the shoreline at any time.
·                  All floating docks, swim platforms, and other permanent structures not permanently affixed to the lake bed are prohibited. No structure extending into White Lake shall be attached to the shoreline by mooring cables or similar tethering devices. 
·                  For shoreline stabilization, please consult the Board for best methods to be used prior to making application.


White Lake Conservancy District
Application/Permit for Shoreline Construction Projects

LAKE OWNER INFORMATION
Applicant (Lake Lot Owner)

Lot Number(s)

Lot Street Address

Lake Owner’s Telephone Number

Lake Owner’s Email Address


CONTRACTOR INFORMATION
Contractor Name

Company Name

Mailing Address

Telephone Number

Email Address

Licensed Contractor
Yes ______             No_______
License ID#


Anticipated Start and End Construction Dates
Start Date

End Date


WLCD to complete:
Application Number

Date Issued


WLCD Board Member Signature/Date
_______________________________________  Date:_________________________________

_______________________________________  Date:_________________________________

_______________________________________  Date:_________________________________