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Erosion Control LCD office use onty Application Checklist Permit Number. Date: Project Name: 78 Oak Street Drive House Reconstruction Please check the appropriate box: l=Included; NA=Not Applicable(if'NA'is checked,an explanation must be provided) Applicant LCD Plan Requirement I NA Location in Plan-page number I NA 1, Detailed written description of how the site will be developed See Checklist Comments (narrative including scope of land disturbing activities and sequence of ✓ construction events) 2. Plan drawing of site(of known scale and including:property lines,lot See Exhibit#3 dimensions,limits of disturbed area,limits of impervious area,land cover / type,natural and artificial water features, 100-yr flood plain,delineated v wetland boundaries,location of all proposed erosion control practices) 3. Direction of runoff flow(elevation contour lines or runoff arrows) t/ See Checklist Comments 4. Watershed size for each drainage area(include all off site run-on and i See Checklist Comments area within the project boundaries) 5, Provisions to prevent mud-tracking onto public thoroughfares i See Checklist Comments during construction(i.e.tracking pad or existing gravel drive) 6 Provisions to prevent the delivery of sediment to stormwater i See Checklist Comments conveyance system(i.e.inlet protection or stone weeper) ) 7. Prevent gully and bank erosion and apply minimum standards See Exhibit#4 for sheet and rill erosion:7.5 tons/acres/year(Universal Soil Loss i Equation-USLE worksheets must be completed and attached) 8. Provisions for sequential steps mitigating the erosive effect of i [ #} See Checklist Comments land disturbing activities(list of erosion control practices) x_t g. Proposed schedule for installation and completion of all k ` See Checklist Comments 1i elements of the erosion control plan(date(s)must be consistent with t/ 1 USLE and be appropriate for each practice) Fxn, 10. Fertilizer and seeding rates(seed,mulch,polymer,fertilizer,etc.) ✓ See Checklist Comments 11. Itemized estimated cost of all elements of the erosion control .,See Page 3. plan including installation and labor(a letter of credit[LOC]is required if estimated cost is greater than$5000) MI 12. Design discharge for ditches and structural measures(flow / See Checklist Comments ii calculations) 13. Cross sections and profiles of road ditches and channels(existing / See Checklist Comments and proposed) v 14. Runoff velocities in channels(to ensure channel stability) ✓ See Checklist Comments 15. Culvert sizes(existing and proposed) I See Checklist Comments 3 16. Proof of stable outlet,capable of carrying the design flow at a lk:rr See Checklist Comments non-erosive velocity(having no ditches,swales,culverts,downspouts,or / & other features that concentrate runoff present and having all runoff leave the �I -�-: site as sheet flow,may be sufficient to satisfy this requirement) ivy9 3 17. Copy of Preliminary Review Letter,permits or approvals by other / See Checklist Comments agencies(e.g.WDNR,Army Corps of Engineers,driveway permit,etc) 18. Any other information necessary to reasonably determine the See Checklist Comments location,nature and condition of any physical or environmental ✓ features of the site *Any proposed changes to the erosion control plan must be submitted and approved prior to implementation. t l Indicates information must always be included Revised January 1,2007