Soil Erosion/sedimentation Residential Controp Part 91 Permit Application Form
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2OFFICE USE ONLY:
SOIL EROSION/SEDIMENTATION RESIDENTIAL
Permit #
__________________
CONTROL PART 91 PERMIT APPLICATION
CITY OF TROY, ENGINEERING DEPARTMENT
Date Issued __________________
Exp. Date
__________________
500 W BIG BEAVER ROAD, TROY, MI 48084-5285
FAX: 248.524.1838
PHONE: 248.524.3383
No Permit Required
Residential: Review fee $10 – Payable in advance
Reviewer
__________________
Permit / inspection fee: New Residential $200,
Minor additions and other $100
Address of property: ________________________________
Sidwell #:
_____________________
Development Name (if applicable) _____________________
T.2N R.11E Section _______________
Subdivision:
________________________________
Lot Number: _____________________
Agent/Applicant: _________________________
Property Owner: __________________________
(Provide Owner Name if Agent is Applicant)
Address: ________________________________
Address: ________________________________
City/State/Zip: ___________________________
City/State/Zip: ___________________________
Phone: _________________________________
Phone: _________________________________
Contact Person: __________________________
Phone: _________________________________
(Name of person responsible for implementation of control measures)
Proposed Earth Change:
Size of Earth Change:
Area ____________________________________ (Acres, Square Footage)
Describe Project: _____________________________________________________________________
_____________________________________________________________________________________________________________________________
Name & Distance to Nearest Lake, Stream or Drain: _________________________________________
Project Start Date:_______________________
Project End Date: _______________
SOIL EROSION PLAN MUST INCLUDE THE FOLLOWING:
•
Project location map showing major thoroughfares and site.
•
Lot number, parcel dimensions, and adjoining right–of-way, (existing and proposed), and street
names include north arrow and scale of drawing.
•
Existing and final contours or elevations of property.
•
Existing, construction and final drainage patterns
•
Dominant existing land features i.e. grass, brush, trees etc.
•
Description of construction and limits of earth disruption.
•
Timing and sequence of earth change (calendar and/or narrative).
•
Permanent land cover i.e. Grass, brush, etc.
•
Graphic location of soil erosion and sedimentation control temporary and permanent measures.
•
Statement on the site plan stating who is responsible for maintenance and that “soil erosion controls
will be maintained weekly and after every storm event.”
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