Residential Soil Erosion Permit Application

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1 CLINTON COUNTY COMMUNITY DEVELOPMENT Residential Soil Erosion Permit Application Soil Erosion, Sedimentation Control and Drainage Enforcement Division Under the Provisions of Part 91 of Act 451, 1994 as Amended 100 E. State St., Suite 1300 St. Johns, MI Phone: (989) Fax: (989) In accordance with Part 91 of PA 451,1994 as amended, and its corresponding General Rules, the undersigned herewith makes application for a Soil Erosion & Sedimentation Control Permit for the following: (Fill out all sections of this permit application or it will not be considered valid.) Type of Construction: House Addition Attached Garage Only Deck Pole Building Detached Garage Other (specify) 1. Address of site: City: Parcel Number: Subdivision: Lot #: Township: Section: Nearest Crossroads: 2. Applicant s Name: Phone: Cell: Fax: Address: City: State/Zip: 3. Builder/Contractor Name: Phone: Cell: Fax: Address: City: State/Zip: 4. Landowner s Name: Phone: Cell: Fax: Address: City: State/Zip: 5. Individual (not the company) responsible for installing/maintaining soil erosion control device(s): Name: Phone/Cell: Address: City: State/Zip: 6. (A) Area in Square Feet of Proposed Improvement (footprint of the building): Sq. Ft. (B) Area in Square Feet of Entire Excavated Area (this includes (A) above): Sq. Ft. (Area of entire excavation or disturbed area as indicated on your site plan) 7. Soil Erosion Controls will need to be installed to protect (check all appropriate): County Drain/Name: Lake/Name: Stream Pond Wetland/Swamp Storm Sewers Streets Other (specify) Revised 03/16

2 8. Does this project require a Permit from the Michigan Department of Environmental Quality (MDEQ)? No Yes If Yes, MDEQ Permit #: 9. Soil Type Information: (Information from the Environmental Health Dept. Perk Test or USDA Soil Survey, if available. If not list soil types as you know them.) 10. Timing Sequence of Excavation: a. What date will the Silt Fence be installed? If Waived, by (Staff Initials) b. What date will coarse aggregate tracking mat stone be delivered? c. What month will construction commence? d. What month will the finish grade be completed? e. What month will the project be complete and ready for vegetative re-stabilization? (example: Sod, Seed and Mulch, Landscaping, etc.) 11. Proposed final stabilization method: Sod Seed/Mulch Hydroseed Other: General Conditions and Responsibilities Issuance of the Soil Erosion and Sedimentation Control Permit does not waive the necessity of obtaining other federal, state, and local permits that may be required. All disturbed areas must be seeded/sodded no more than 5 days after final grade is established. Temporary soil erosion and sedimentation control measures must remain until permanent stabilization measures are in place. If a change in ownership of the property occurs prior to the closure of the permit, a Permit Transfer (will be prov ided with permit) to the new owner is required. If the permit is not transferred, the original permittee will remain the responsible party for any fines, fees, or enforcement action. This application serves as written consent for the Clinton County Community Development office to enter onto the site for the purpose of inspection. 12. Owner & Applicant Signatures (Two signatures are required) I (we) affirm that the information provided on this application is accurate and that I (we) will comply with the requirements of Part 91 and its corresponding rules, the Clinton County Soil Erosion and Sedimentation Control Ordinance, and applicable local ordinances. I (we) acknowledge that I (we) have read and will comply with the general conditions and responsibilities as outlined in this application. I hereby certify that I have read and understand the terms and conditions as stated above. Owner s Signature : Date : Applicant s Signature : Date : Revised 03/16

3 RESIDENTIAL CLINTON COUNTY SOIL EROSION AND SEDIMENTATION CONTROL FEE SCHEDULE Permit Permit Project Type Fee Duration New Home $125 6 months Addition $75 6 months Assessory Building not exceeding 1000 sq. ft. $75 6 months In-ground Pool 6 months Pond $75 6 months *Must re-apply for new permit after 8 months Extension Fee* (2 months only) COMMERCIAL Project Type Plan Permit Incremental Surety Permit Extension Review Base Fee Adjustment Required Duration Fee (first acre/mile) (Each Add'l acre/mile) (Per Acre/mile) Commercial & Residential Site Development Projects $250 $250 ac. $125 ac. $750 ac. 12 months No Extensions (Includes development of new roads) Cut and Fill Operations $100 $250 ac. $125 ac. $750 ac. 4 months ac. (2 mo.) (Includes mass grading projects) Surface Mining Operations $250 0 ac. n/a $750 ac. 24 months $250 (12 mo.) (Total acreage from SUP application) Utilities $100 $150 mi. mi. $1000 mi. 6 months No Extensions (Permit fee may be waived for plowed in utilities) ADDITIONAL INFORMATION All fees will be required prior to the issuance of permit. Fee will be doubled for starting work without a permit. A waiver is issued for projects that do not require a SESC permit. There is no charge for a permit waiver. Surety may be in the form of a surety bond, certified check, or irrevocable bank letter of credit. A Permit Transfer is required if the property changes ownership prior to the closure of the permit. There is no charge for the transfer. Issuance of a Notice of Violation will result in an additional $100 charge to the permit holder. Adopted by Clinton County Board of Commissioners 12/15/06 Effective Date January 1, 2007

4 FEE INFORMATION MAKE CHECKS PAYABLE TO: CLINTON COUNTY BUILDING DEPARTMENT *See attached fee schedule*

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7 CLINTON COUNTY ENFORCING AGENT SOIL EROSION AND SEDIMENTATION CONTROL PERMIT TRANSFER PERMIT # PARCEL # SITE ADDRESS: NEW RESPONSIBLE PARTY: Name Address City State Zip Daytime Phone ORIGINAL RESPONSIBLE PARTY: Name Address City State Zip Daytime Phone The New Responsible Party must review the permit, receive the approved site plan and become familiar with the conditions of the permit. A new permit will be sent after being approved. We affirm that the above information is accurate and that the new responsible party of the property has been made aware of the conditions stated in the original Soil Erosion and Sedimentation Control Permit and the penalty for not adhering to the permit conditions and schedule. The new responsible party acknowledges the responsibility for maintenance of soil erosion and sedimentation control measures and for the establishment of permanent stabilization. New Responsible Party s Signature Print Name Date Original Responsible Party s Signature Print Name Date The Soil Erosion transfer form will be complete upon an approved site inspection and a zero balance on the Soil Erosion permit. A disapproved inspection will result in a denial of the Soil Erosion transfer and all associated fees will be held to the Original Responsible Party. (For Office Use Only) Date of Inspection Approved Disapproved Condition of Site Inspector s Signature Date For additional information please contact: Al Hoard or Joel Haviland Soil Erosion Administrators 100 E. State St., Suite 1300 St. Johns, MI Phone: (989) Fax: (989)

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