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Erosion Control LCD uSe only <br /> Application Checklist Permit Number. . , <br /> Date: <br /> Project Name:368 Lake Shore Drive House Reconstruction <br /> Please check the appropriate box: I=Included;NA=Not Applicable Of 'NA is checked,an explanation must be provided) <br /> Applicant _ LCD <br /> Plan Requirement I NA Location in Plan-page number I NA <br /> 1. Detailed written description of how the site will be developed <br /> See Checklist Comments <br /> (narrative including scope of land disturbing activities and sequence of <br /> construction events) <br /> 2. Plan drawing of site(of known scale and including:property lines,lot See Exhibit#3 <br /> dimensions,limits of disturbed area,limits of impervious area,land cover <br /> type,natural and artificial water features, 100-yr flood plain,delineated <br /> wetland boundaries,location of all proposed erosion control practices) <br /> 3. Direction of runoff flow(elevation contour lines or runoff arrows) It , _ <br /> See Checklist Comments <br /> 4. Watershed size for each drainage area(include all off site run-on and <br /> See Checklist Comments <br /> area within the project boundaries) ,/ <br /> 5, Provisions to prevent mud-tracking onto public thoroughfares <br /> See Checklist Comments <br /> during construction(i.e.tracking pad or existing gravel drive) 1/ 1, <br /> 6 Provisions to prevent the delivery of sediment to stormwater <br /> See Checklist Comments <br /> conveyance system(i.e.inlet protection or stone weeper) :, <br /> 7. Prevent gully and bank erosion and apply minimum standards ^of.; <br /> See Exhibit#4 <br /> for sheet and rill erosion:7.5 tons/acres/year(Universal Soil Loss ;- <br /> Equation- USLE worksheets must be completed and attached) <br /> 8. Provisions for sequential steps mitigating the erosive effect of / fir- See Checklist Comments <br /> land disturbing activities(list of erosion control practices) Wil, <br /> 9. Proposed schedule for installation and completion of all � '��• <br /> SSee Checklist Comments <br /> elements of the erosion control plan(date(s)must be consistent with $ <br /> USLE and be appropriate for each practice) ' <br /> ✓ `•See Checklist Comments <br /> 10. Fertilizer and seeding rates(seed,mulch,polymer,fertilizer,etc.) .- <br /> 11. Itemized estimated cost of all elements of the erosion control �.ra�, <br /> See Page 3. <br /> plan including installation and labor(a letter of credit[LOC]is i ,ii ,_ <br /> required if estimated cost is greater than$5000) y. <br /> 12. Design discharge for ditches and structural measures(flow <br /> See Checklist Comments <br /> calculations) <br /> 13. Cross sections and profiles of road ditches and channels(existing / See Checklist Comments <br /> and proposed) . <br /> 14. Runoff velocities in channels(to ensure channel stability) <br /> ✓ See Checklist Comments <br /> 15. Culvert sizes(existing and proposed) <br /> ✓ See Checklist Comments <br /> 3 <br /> 16. Proof of stable outlet,capable of carrying the design flow at a t See Checklist Comments <br /> / M ;, <br /> non-erosive velocity(having no ditches,swales,culverts,downspouts,or v f. <br /> other features that concentrate runoff present and having all runoff leave the <br /> site as sheet flow,may be sufficient to satisfy this requirement) .- <br /> 17, Copy of Preliminary Review Letter,permits or approvals by other <br /> See Checklist Comments <br /> agencies(e.g.WDNR,Army Corps of Engineers,driveway permit,etc) <br /> 18. Any other information necessary to reasonably determine the / <br /> See Checklist Comments <br /> location,nature and condition of any physical or environmental 1r <br /> features of the site - <br /> *Any proposed changes to the erosion control plan must be submitted and approved prior to implementation. <br /> Indicates information must always be included <br /> Revised Januar"2. 2007 <br />