Erosion and Sedimentation Control Permit Application

gayoldMécanique

21 févr. 2014 (il y a 3 années et 8 mois)

54 vue(s)


PERMlT#

____________________________
NEW L
ONDON TOWNSHIP
EROSION AND SEDIMENTATION CONTROL PERMIT APPLICATION
PROJECT DESCRIPTION
Name of Project:

________________________________________________________________
Pro
ject Description:

_____________________________________________________________
Loc
ation:

______________________________________________________________________
Tax P
arcel # 71-

_________________________

Tot
al Acreage:

_________________________
Desc
ription of Area to be disturbed:

________________________________________________
______________________________________________________________________________
ACC
OMPANYING SEDIMENT and EROSION PLANS AND DOCUMENTS
Author of E & S Control Plan accompanying this application:
Name:

________________________________

Add
ress:

______________________________
Tem
porary E & S Control Measures:

________________________________________________
Ant
icipated Completion Date for Final Stabilization:

___________________________________
APP
LICANT DATA
Applicant:

_____________________________ Te
lephone:

______________________________
Add
ress:

______________________________________________________________________
Own
er of Record:

_______________________________________________________________
Add
ress:

______________________________________________________________________
APP
LICANTS SIGNATURE:

___________ DA
TE:

_________________________________
Ple
ase call Township Engineer,
Ron Ragan at 610-255-3400 to
schedule “Implementation” and
“Stabilization” inspections.
PLAN APPROVAL

INSPECTION (Implementation)
SIGNATURE:

_________________________

SIG
NATURE:

_________________________

(Zoning Officer)

(Township Engineer)
DATE:

_______________________________

DATE:

_______________________________
INS
PECTION (Stabilization)
SIGNATURE:

_________________________

(Township Engineer)
DATE:

_______________________________