I Original Application Received 10.06.20

STANDARD LEASE APPLICATION: NON-DISCHARGE

1. APPLICANT CONT ACT INFORMATION

Applicant

Contact Person

Address

City

State, Zip

County

Telephone

Email

Type of Application

Dates

0J Draft Application Iii Final Applicationl submitted before scoping session session] [ submitted after scoping session]

Pre-Application Draft Application Meeting: l 1-? 1-cJ Submittcd10 / 2-f)

Scoping Session:

I 2.lJ Note: If applicant is a corporation or a partnership, the "Corporate Applicant lnfmm tion Do ument" available at: http://www.maine.gov/dmr/aquaculture/fonns/standard.html must also be completed.

2. PROPOSED LEASE SITE INFORMATION

Location of Prooosed Lease Site

Town Sf CJ ll j J'L,,, 7c) /)Waterbody /Oe.110/o.i ({{)t IS C\.(..1,.

General Description Stv ofl Andvt� _fs-/4 nJ fe. I!. south ofB Island) Lease Information

Total acreage requested J,2-tf (I 00-acre maximum) Lease term requested

-;__{') (20-vear maximum)

Type of culture ( check all D Bottom (no gear) that apply) 18 Suspended (gear in the water and/ or on the bottom)

Is any portion of the D Yes [ii No proposed lease site

above mean low water? Note: If you selected yes, you need to complete the steps outlined in the section titled: "19. Landowner/Municipal Permission Requirements".

1 j I'",, e

Final App Received: 06.29.21Revised Final App: 09.30.21Deemed Complete: 10.07.21

Draft