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LCD office USE,only <br /> Erosion Control <br /> Application Checklist _.... .. <br /> Permit <br /> Date: <br /> Project Name: 394 Lake Shore Drive House Reconstruction <br /> ern Please check the appropriate box: l=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 / See Checklist Comments <br /> IP <br /> (narrative including scope of land disturbing activities and sequence of v <br /> ith 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 / 1 <br /> type,natural and artificial water features, 100-yr flood plain,delineated b <br /> ilii wetland boundaries,location of all proposed erosion control practices) <br /> 3. Direction of runoff flow(elevation contour lines or runoff arrows) ✓ See Checklist Comments <br /> Ili 4, Watershed size for each drainage area(include all off site run-on and See Checklist Comments <br /> area within the project boundaries) t-t,,-:, <br /> 5. Provisions to prevent mud-tracking onto public thoroughfares Checklist Comments <br /> during construction(i.e.tracking pad or existing gravel drive) b:41,,, <br /> ill <br /> a <br /> 6 Provisions to prevent the delivery of sediment to stormwater See Checklist Comments <br /> / � . <br /> conveyance system(i.e.inlet protection or stone weeper) �/ " <br /> 7. Prevent gully and bank erosion and apply minimum standards See Exhibit#4 <br /> i 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 / .1 See Checklist Comments <br /> di land disturbing activities(list of erosion control practices) <br /> 9. Proposed schedule for installation and completion of all ' See Checklist Comments <br /> elements of the erosion control plan(datets)must be consistent with ✓ bf <br /> USLE and be appropriate for each practice) <br /> di «; <br /> 10. Fertilizer and seeding rates(seed,mulch,polymer,fertilizer,etc.) ✓ See Checklist Comments <br /> 11. Itemized estimated cost of all elements of the erosion control See Page 3. <br /> plan including installation and labor(a letter of credit[LOC]is ft <br /> required if estimated cost is greater than$5000) ;° , <br /> 12. Design discharge for ditches and structural measures(flow / See Checklist Comments <br /> calculations) <br /> #111 13. Cross sections and profiles of road ditches and channels(existing / See Checklist Comments <br /> and proposed) V <br /> 14. Runoff velocities in channels(to ensure channel stability) ✓ See Checklist Comments <br /> 15. Culvert sizes(existing and proposed) ✓ See Checklist Comments <br /> 4. <br /> 16. Proof of stable outlet,capable of carrying the design flow at a --'4,See Checklist Comments <br /> non-erosive velocity(having no ditches,swales,culverts,downspouts,or / `' <br /> other features that concentrate runoff present and having all runoff leave the v - y <br /> site as sheet flow,may be sufficient to satisfy this requirement) ' - <br /> 17. Copy of Preliminary Review Letter,permits or approvals by other i See Checklist Comments <br /> A 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 /> features of the site <br /> T,., <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 /> I1 <br /> Revised Januan 2.2007 <br /> iinr <br />