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CLINTON COUNTY COMMUNITY DEVELOPMENT Commercial 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 48879 Phone: (989) 224-5181 Fax: (989) 227-6492 (Fill out all sections of this permit application or it will not be considered valid.) In accordance with Part 91 of Act 451, 1994, as amended and its corresponding General Rules, the undersigned herewith makes application for a grading permit for the following required fields: 1. GENERAL INFORMATION (Type or Print Clearly in Ink) Required: All Commercial Soil Erosion & Sedimentation Control Applications must be accompanied by two signed & sealed copies of Soil Erosion & Sedimentation Control Plan prepared under the direction of a professional engineer certified in the State of Michigan that meets or exceeds SESC plan requirements, unless waived in writing by the County Enforcing Agency. Development Name : Work to be performed: Commercial Industrial Other Street Name Township :, Section (s): Parcel Number: Street Address (if applicable): Nearest Major Crossroads: 2. APPLICANT INFORMATION Applicant Name Firm Name if Applicable Daytime Phone Pager/Cell 3. LAND OWNER INFORMATION Landowner Name Daytime Phone Pager/Cell 4. ON-SITE RESPONSIBLE INDIVIDUAL INFORMATION (NOT THE COMPANY) Name Firm Name if Applicable Daytime Phone Pager/Cell

5. EROSION AND SEDIMENTATION CONTROL PLAN BY INFORMATION Contact Name : Firm Name: Daytime Phone Pager/Cell 6. PROJECT INFORMATION a. Type of earth change: b. Total area of parcel (in acres) : Total area of proposed earth change (in acres): c. Anticipated earthwork starting date: Anticipated final inspection date : d. Type of soil(s) : e. Check type of drawings submitted with application: Location Map Topographic Map Site Development Plan Final Grading & Drainage Plan Erosion & Sediment Control Plan (Mandatory) Other: 7. PERFORMANCE DEPOSIT (If Required) Amount Required $ Cash Check Name of Company: Address: City: State: Zip: Phone: Fax: E-mail: Local Agent: Address: City: State: Zip: Phone: Fax: E-mail: 8. HYDROLOGIC CHARACTERISTICS OF SITE INFORMATION Type of Ultimate drainage outlet(s) (Check if applicable and complete the right column) Existing Proposed : Distance to Existing : Open County Drain Lake / Pond River / Stream Enclosed Drain Name of Open County Drain: Name of Lake / Pond: Name of River / Stream: Name of Drain: Detention Basin (with outlet) Retention Basin (no outlet) Wetland Open Ditch Overland Flow Private Storm System

9. MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY (MDEQ) a. Will the project include any work or disruption within a 100 year flood plain? - Yes No b. Does project include any work within the cross-section of a lake / stream / drain / wetland? Yes No c. Will the earth disturbance be one or more acres and discharge a lake / stream / drain / wetland? Yes No d. Is a M.D.E.Q. Permit required? Yes No e. If - Yes - Provide MDEQ PERMIT # 10. Part 31, STORM WATER PERMITS All proposed earth disturbance sites of five acres or larger are required to obtain an N. P. D. E. S. (National Pollution Discharge Elimination Systems) permit/notice of coverage from the M.D.E.Q. prior to the commencement of earth disturbance. Permit application forms are available from the Office of the Clinton County Community Development Office and the address below: Donna Cervelli Michigan Department of Environmental Quality Storm Water Permits - S W Q D Construction Fees P.O. Box #30439 Lansing, MI 48909-7939 517-335-6266 11. STORM WATER OPERATOR INFORMATION If 5 acres or more disturbed, indicate Storm water manager. Name : Firm Name : Certification : # Expiration Date : Address : City : State Zip : Fax : # Pager : # Daytime Phone :# E- Mail : 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 provided 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.

Soil Erosion and its resulting sedimentation to water systems is identified as the #1 threat to the surface waters of the State of Michigan. Millions of tons of soil are lost across the country each year and millions of dollars are spent in correcting the problems brought on by this form of environmental degradation. 1. The landowner (permittee) or legal representative of the permittee on an approved permit is responsible for installation and maintenance of soil erosion and sedimentation control measures and the ultimate stabilization of the site. If the property is sold and legal transfer of the permit has not transpired, i.e., new owners signature on the existing original permit, the original Permittee is held responsible for all fines and stabilization measures for compliance with Part 91. 2. If the County Enforcing Agent (CEA) fo r Part 91, the Clinton County Community Development Office, finds it necessary to issue a violation to a permit holder, violations shall be addressed immediately. A person shall not maintain or undertake an earth change governed by Part 91 rules or the County s SESC ordinance, except in accordance with Part 91, the rules or ordinance and pursuant to the plan and permit approved by the County Enforcing Agency. A person who violates this is guilty of a misdemeanor. 3. The permit holder is responsible for the attainment of site stabilization. A site that is defined as being stabilized is one that has achieved its prescribed final grading and vegetative establishment or other covering resistant to erosion as per the approved SESC plan (i.e. a good stand of grass is present as defined by the inspector). 4. In order to prevent soil erosion and subsequent sedimentation of streams, lakes, and wetlands and to keep sediment on the site, the undersigned applicant agrees to faithfully implement the following practices during and after the construction process: a. Avoid unnecessary removal of existing vegetative soil cover. b. Divert any runoff water into areas where the sediment will settle out of the runoff water before it leaves the site. c. Sod, seed and mulch, or use other approved erosion control measures on all disturbed areas as soon as possible after final grade is established (not more than 5 days). d. Apply fertilizer and lime in amount adequate for the soil type. e. During the construction process and until final grade can be established, seed all bare areas with temporary vegetative cover such as rye grass and oats. f. Provide and maintain any structures, rip-rap, or other permanent means to control possible future erosion of soil from the site. 5. The permit holder is also responsible for maintaining the validity of the permit bond throughout the duration of construction and ultimate stabilization of a site. If the Bond expires and the site lacks proper stabilization, the permit holder will be notified by certified mail. If thirty days passes, the permit will expire. At that time the permit holder shall be required to apply to the Clinton County Community Development Office for a new permit and be responsible for all fees. 6. The SESC inspector m ay req uire add itional control measures if a site inspection ind icates th at original measures are not sufficient to prevent erosion. 7. The permit holder acknowledges and gives permission to the CEA or agents of the CEA to enter the property for inspection purposes. 12. OWNER & APPLICANT SIGNATURE S (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 i ts 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 have read the application instructions and completed the permit applicati on. I understand that applications not fully completed will be delayed. I hereby acknowledge that I have read the above statement of responsib ility under Part 91 and understand my responsibilities. Owner s Signature : Date : Applicant s Signature : Date : 2 SIGNED& SEALED EROSION & SEDIMENT CONTROL PLANS MUST BE SUBMITTED WITH THIS APPLICATION

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