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dii <br /> Erosion Control LCD office uses n <br /> 4 <br /> id Application Checklist Permit Number , , <br /> Dater' <br /> Project Name:346 Lake Shore Drive House Reconstruction <br /> as <br /> Please check the appropriate box: l=Included; NA=Not Applicable Of'NA'is checked,an explanation must be provided) <br /> Applicant LCD <br /> Id <br /> Plan Requirement I NA Location in Plan-page number I NA <br /> it <br /> 1. Detailed written description of how the site will be developed See Checklist Comments <br /> iiii (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 /> ilMi type,natural and artificial water features, 100-yr flood plain,delineated v 5 <br /> wetland boundaries,location of all proposed erosion control practices) _` <br /> 4 <br /> 3. Direction of runoff flow(elevation contour lines or runoff arrows) ✓ r See Checklist Comments <br /> ail 4. Watershed size for each drainage area(include all off site run-on and ' See Checklist Comments <br /> area within the project boundaries) v <br /> 5. Provisions to prevent mud-tracking onto public thoroughfares 1 See Checklist Comments <br /> vie during construction(i.e.tracking pad or existing gravel drive) <br /> 6 Provisions to prevent the delivery of sediment to stormwater / ` ;See Checklist Comments <br /> conveyance system(i.e.inlet protection or stone weeper) <br /> WI 7. Prevent gully and bank erosion and apply minimum standards .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) x <br /> ti 8. Provisions for sequential steps mitigating the erosive effect of ;;, See Checklist Comments <br /> land disturbing activities(list of erosion control practices) ! <br /> ,1 9. Proposed schedule for installation and completion of all See Checklist Comments <br /> elements of the erosion control plan(datets)must be consistent with <br /> oili USLE and be appropriate for each practice) t <br /> 10. Fertilizer and seeding rates(seed,mulch,polymer,fertilizer,etc.) ✓ ,;' See Checklist Comments <br /> 111 <br /> ` 11. Itemized estimated cost of all elements of the erosion control See Page 3. <br /> di plan including installation and labor(a letter of credit[LOC]is / . . <br /> required if estimated cost is greater than$5000) ° < <br /> 12. Design discharge for ditches and structural measures(flow i See Checklist Comments <br /> ail calculations) <br /> 13. Cross sections and profiles of road ditches and channels(existing / See Checklist Comments <br /> and proposed) 1� <br /> tl 14. Runoff velocities in channels(to ensure channel stability) I See Checklist Comments <br /> 15. Culvert sizes(existing and proposed) ✓ See Checklist Comments <br /> 16. Proof of stable outlet,capable of carrying the design flow at a - ,See Checklist Comments <br /> ' <br /> tti non-erosive velocity(having no ditches,swales,culverts,downspouts,or <br /> other features that concentrate runoff present and having all runoff leave the / fti. E <br /> site as sheet flow,may be sufficient to satisfy this requirement) - < <br /> off 17. Copy of Preliminary Review Letter,permits or approvals by other i 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 See Checklist Comments <br /> location,nature and condition of any physical or environmental ✓ <br /> tiiiil 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 January 2.2007 <br /> till <br />