Permit and Site Forms
(Letters in bold/capital are variable
names for database purposes)
Check if site areas U or descriptions U
recorded or corrected on back of form.
( Form date /
Form by (use three initials)
Data entered / / by
MICR Freshwater Woody
MICR Freshwater Herbaceous
MICR Saltwater Woody
MICR Saltwater Herbaceous
MIRE Freshwater Woody
MIRE Freshwater Herbaceous
MIRE Saltwater Woody
MIRE Saltwater Herbaceous
MIEN HYdrologic improvement
MIEN EXotic Removal
MIEN OTher (specify on back)
MI Preservation oN-site
MIPN WEtland preservation
MIPN UPland preservation
MI Preservation oFf-site
MIPF WEtland preservation
MIPF UPland preservation
i of sites if yes
DEsign (plans and permit)
DE mitigation PLan w/permit Y N
DE Soils Infor. with plan Y N
DE Planting Scheme w/plan Y N
DE MOnitoring reports req AN BI QU MO N
DE Success Criteria specified Y N
DE Exotic Control specified Y N
DE other MAint. required Y N
DE Correct Measures specified Y N
DE AS-Built required Y N
DE permit Condition Problems Y N
DE MUlch required Y N
DE Hydrologic Monitoring req Y N
DE Planting Required Y N
DE Plant Inventory required Y N
DE no. of MOnitoring YeaRs
DE Deed Restrictions Y N
DE Conservation Easement Y N
DE COnstruction start DaTe: /
Permit # -- (no "A")
Check if related #/initials are new or update U.
Related # A (w/ "A")
Compliance by (use three initials)
permit COmpliance (administrative)
CO MOnitoring reports
COMO DUe DaTe
COMO REceived DaTe
CO Easement Restrictions
COER DUe DaTe
COER EXhibits received DaTe
COER Legal Review
COER APproved DaTe
COER Certified copy Due DaTe
COER Cert. copy Received DaTe
COAS DUe DaTe
COAS REcevied DaTe
CO Hydrologic Monitoring
COHM report REceived
COHM DUe DaTe
COHM REceived DaTe
CO Plant Inventory REceived
Y N NR
Y N NR
Y N NR
Y N NR
Y N NR
CO PErmit compliance
COPE In Compliance Y N
COPE measures NEcessary ADMIN SITE BOTH N
COPE Schedule Revisit Y N
COPESR DaTe / /
AC Permittee Notified
AC DUe DaTe
AC Response Received
AC Problems Corrected
AC EXtension letter
CALL MTG LTR
Y N SOME
TI ACtion COMO COER COAS COHM COPESR AC
TI DaTe /
Site ID: 1, left justified, or 2 characters, either letters, numbers, or a combination. A site is the smallest defined
mitigation area; however, at your option, two or more areas may be treated as a single site, e.g., sections of a
littoral zone, as appropriate. For creation, restoration and enhancement, if more than one type occurs per area,
subdivide the area and label as separate sites if possible; otherwise, count the primary type. For mixed on- or off-
site preservation, split the area into separate sites of upland and wetland preservation. Use these ID's on the
SITE mitigation form exactly as recorded here. Size is in acres; record -9 for unknown planned or actual size.
Site Planned Actual Site Location & Description (Note: maximum of 99 lines allowed per
ID Size Size site, but only the first line will appear on the summary report.)
Record rule #'s as 4, 6, 12 and 40 only. Attach additional sheet if necessary.
Permit #: MSSW or WRM number for the permit with the mitigation; use a second form only if the related permit
has additional mitigation. There is one PERMIT form regardless of the number of sites for each permit.
Related #: the related WRM or MSSW number if there were two permits. If the permit # is an MSSW, then the
related # must be a WRM and vice versa.
Compliance by: the person assigned primary responsibility for monitoring compliance of this permit #.
Data entered: completed by the computer data entry person.
Form date: completion date for filling out this form.
Form by: the reviewer or compliance person completing this form and responsible for the data.
Code values: AN: Annual, BI: Biannual, MO: monthly, N: no, NA: not applicable, NR: not required, QU: quarterly,
R: Required, Y: yes. (also see non-standard and unknown below)
Non-standard codes: check permit and site libraries for new or special codes and record them next to the
variable name (the sequence of bold characters).
Unknowns: leave the variable blank, i.e., do not record anything. For dates, leave blank if entire date unknown;
otherwise, record 15 for day and estimate the month, record 6 for month if only the year is known. Note that
some dates with day=15 may appear "completely valid" when they are only approximately Therefore, do not use
day=15 when the date is known exactly.
Unable to determine: record "dot" (period) for character codes; -9 for numbers.
Mitigation: circle yes if the category, e.g., creation, occurs in the permit; otherwise circle no.
# of sites if yes: record no. of sites (including zeros) only if the mitigation category is circled yes; otherwise leave
the numbers blank.
DEsign: were these items included in the permit application or required as a permit condition.
COmpliance: record compliance status for each required condition; otherwise circle NR.
COPErmit: record summary of both administrative and site compliance status. Schedule both routine and follow-
up field visits.
ACtion measure: record progress of enforcement action necessary to bring the permit into compliance.
Tickle: based on your action and review, record the next action and the future reminder date for this permit.
NOTES: (reference bold letters for each comment)
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