REQUEST FOR SERVICES FROM INGHAM COUNTY DRAIN COMMISSIONER S OFFICE

Transcription

1 REQUEST FOR SERVICES FROM INGHAM COUNTY DRAIN COMMISSIONER S OFFICE PROJECT: PROJECT NAME PROPERTY TAX ID No 33- PROJECT LOCATION (STREET ADDRESS, CITY/TOWNSHIP/VILLAGE), STATE, ZIP CODE DRAIN NUMBER (See Drain Office) DRAIN NAME (See Drain Office) LANDOWNER: NAME PHONE No. (HOME, OFFICE) STREET ADDRESS (Number and Name) PHONE No. (CELL, SITE) FAX No. CITY, STATE, ZIP CODE ADDRESS ENGINEER: NAME PHONE No. (OFFICE,HOME, SITE, CELL) COMPANY FAX No. COMPANY ADDRESS (STREET, CITY/TOWNSHIP/VILLAGE), STATE, ZIP CODE ADDRESS Total Acres: Disturbed Acres: o PLAT REVIEW o Preliminary Plat Site Plan Drainage Review $ o Preliminary Plat Construction Plan Review based on Total Acres above 1 First acre $ Each Additional Acre is $79.00/Acre (Fractions of Acres are rounded up to the Whole Acre) $ TOTAL $ o COMMERCIAL REVIEW o Commercial Site Plan Review $ o Commercial Drainage Review - based on Total Acres above 1 First acre $ Each Additional Acre is $79.00/Acre (Fractions of Acres are rounded up to the Whole Acre) $ TOTAL $ o COMMERCIAL SOIL EROSION AND SEDIMENTATION CONTROL PERMIT REVIEW o Application site review, issuance of permit, and permit closeout site review based on Disturbed Acres above 2 First acre (6-month duration) $ Each Additional Acre is $46.00/Acre (Fractions of Acres are rounded up to the Whole Acre) $ First acre (9-month duration) $ Each Additional Acre is $53.00/Acre (Fractions of Acres are rounded up to the Whole Acre) $ 1 For example: For 4.5 acres, the Fee for the first acre included is $695 and the remaining 3.5 acres is rounded up to 4 acres, then multiplied by $78/acre, and equals $312. And, the two amounts combined equal the Review Fee Total of $ For example: For 4.5 acres, for a 6-month duration permit, the Fee for the first acre included is $450 and the remaining 3.5 acres is rounded up to 4 acres, then multiplied by $45/acre, and equals $180. And, the two amounts combined equal the Review Fee Total of $630. PATRICK E. LINDEMANN, INGHAM COUNTY DRAIN COMMISSIONER Tele.: (517) Buhl Ave., Mason MI Page 1 of 3 Fax: (517) Website: drain.htm Revised as of 1/1/2018

2 INCOMPLETE APPLICATIONS WILL BE RETURNED! REQUEST FOR SERVICES FROM INGHAM COUNTY DRAIN COMMISSIONER S OFFICE PROJECT: PROJECT NAME First acre (12-month duration) $ Each Additional Acre is $61.00/Acre (Fractions of Acres are rounded up to the Whole Acre) $ TOTAL $ o Commercial Minor Disturbance (determined by Ingham County Drain Commissioner) $ o COMMERCIAL SOIL EROSION AND SEDIMENTATION CONTROL PERMIT ESCROW (Do not submit escrow with application) 3 o Less than half-acre $ o Half-acre up to one acre $ o One acre up to five acres $ o Five acres up to ten acres $ o Each additional ten acres or fraction of ten acres $ (Inspections will be charged at an hourly rate. Escrow may be adjusted by the ICDC based on certain site factors. Unspent balance will be refunded. Overages will be invoiced) o AGREEMENT REVIEWS o 425/433 Agreement Fee 4 $ o Other Agreements (Fee to be determined by Ingham County Drain Commissioner) $ o MISCELLANEOUS o Title Search for Drain Assessments $5.00 o License to Encroach Hourly rates for the positions involved, including the Drain Commissioner, Deputy Drain Commissioner, and Clerk Specialist, as well as a $30.00 deposit at the time of the request $ TBD 5 o Freedom of Information Requests Fee Determined by County Policy (see FOIA form) $ TBD 5 o Geographical Information Systems (GIS) Maps o Photography $ per quarter section or part thereof o Topography $ per quarter section or part thereof o Drain Crossing Permit o Residential $ o Commercial $ o Tap-In Permit o Residential $ INCOMPLETE APPLICATIONS WILL BE RETURNED! 3 Inspections will be charged at an hourly rate. Specific escrow will be determined by the ICDC based on site factors. Escrow amount will be indicated in issued permit. Escrow will need to be submitted prior to the commencement of earth disturbance. Unspent balance will be refunded and overages will be invoiced. 4 Fee does not cover outside legal and/or engineering consultants that may be needed in review of agreement. Those additional costs will be billed to Applicant. Fee also does not cover 5% Maintenance or 8% Storm Drain Inspection costs. 5 To be determined. PATRICK E. LINDEMANN, INGHAM COUNTY DRAIN COMMISSIONER Tele.: (517) Buhl Ave., Mason MI Page 2 of 3 Fax: (517) Website: Revised as of 1/1/2018

3 INCOMPLETE APPLICATIONS WILL BE RETURNED! REQUEST FOR SERVICES FROM INGHAM COUNTY DRAIN COMMISSIONER S OFFICE PROJECT: PROJECT NAME o Commercial $ o Tap-In/Crossing Inspection Deposit (All costs for inspection are the responsibility of permitee. Unspent balance will be refunded. Overages will be invoiced) $ o Other $ TBD 6 Decription of Services: o TOTAL FEES FOR ALL SERVICES CHECKED ABOVE: $ Please, make checks payable to: Ingham County Drain Commissioner. Date Paid: o I hereby request the services checked above and agree to pay the applicable fees. Signature Date EACH SUBMITTAL will be processed when: 1) All Fees are paid 2) Forms are completed (BLANK AREAS ON FORM ARE ALL FILLED IN) 3) Three (3) Sets of Plans are submitted for each different review requested on a project. (For example, if requesting a SEP Permit and a Tap-in Permit, submit 3 sets of plans with the SEP application and 3 sets of plans with the Tap-in application) INCOMPLETE APPLICATIONS WILL BE RETURNED! 6 To be determined. PATRICK E. LINDEMANN, INGHAM COUNTY DRAIN COMMISSIONER Tele.: (517) Buhl Ave., Mason MI Page 3 of 3 Fax: (517) Website: Revised as of 1/1/2018

4 Date Issued Ingham County Drain Commissioner Patrick E. Lindemann 707 BUHL AVENUE P. O. BOX 220 MASON MI PH. (517) FAX (517) APPLICATION FOR SOIL EROSION AND SEDIMENTATION POLLUTION CONTROL PERMIT Expiration Date PERMIT NO. Permit Code R RMD C CMD W AG APPLICANT Name Landowner Authorized Agent (Please check if applicant is the landowner or authorized agent*) Phone # Fax # Address City State Zip PROJECT LOCATION AND PROPOSED EARTH CHANGE Township/City/Village Property Tax ID Number (Obtain from local government agency) Section Street Address Describe Proposed Earth Change Subdivision Size of Earth Change (acres or square feet) Lot No. Distance To Lake, Stream, Wetland, Catch Basin Site Plan Preparer Site Plan Preparer Phone # < 500 FEET > 500 FEET PARTIES RESPONSIBLE FOR EARTH CHANGE Landowner Address Phone # Fax # City State Zip On-site Contact Person Company Name (If applicable) Address Mobil Phone # Fax # City State Zip I (we) affirm that the above information is accurate and that I (we) will conduct that above described earth change in accordance with Part 91, its corresponding rules, applicable local ordinances, and the documents accompanying this application. I acknowledge that I have read and will comply with the general conditions and responsibilities as outlined in the application. This application serves as written consent for the Ingham County Drain Commissioner s Office to enter onto a site for the purpose of inspection. Please Note: 1) Contact inspector for final inspection. 2) Permit holder is cautioned that grade changes resulting in increased run-off onto adjacent property is subject to civil litigation. 3) This permit does not exempt permit holder from obtaining other permits issued by state or local agencies. Landownerʼs Signature Print Name Date Authorized Agentʼs Signature* Print Name Date *Authorized agent must have a written statement from landowner authorizing him/her to secure a permit in the landownerʼs name. OFFICE USE ONLY Revised 1/1/2018 Check No. Amt. Rec'd Receipt No. Receipt Type Inspector Drainage District # S.E.P. Permit Fee $ Preliminary Site Review $ Performance Deposit $ Administrative Fee (425/433 Agreements) $ Crossing Permit $ Crossing Permit / Tap-in Permit Inspection Fee $ Violation Fee $ Drainage District Name Drainage Review Fee $ 8% Inspection Fee $ 5% Maintenance Deposit $ Performance Deposit Payment CASH/CHECK BOND LETTER OF CREDIT Transfer Fee $ Renewal Fee $ Inspection Escrow $ Tap-in Permit $ Cease & Desist Fee $ Resubmission Fee $

5 INGHAM COUNTY DRAIN COMMISSIONER PATRICK E. LINDEMANN 707 BUHL AVENUE P. O. BOX 220 MASON, MI (517) FAX (517) Part 91, Soil Erosion And Sedimentation Control Of The Natural Resources And Environmental Protection Act, Act 451 Of The Public Acts Of 1994, AS AMENDED Being Sections To Of The Michigan Compiled Laws. SOIL EROSION AND SEDIMENTATION CONTROL RULES R TO R RULES AND PROCEDURES OF THE INGHAM COUNTY DRAIN COMMISSIONER, Requirements FOR COMMERCIAL Soil Erosion And Sedimentation POLLUTION Control Permit # GENERAL REQUIREMENTS 1. The law requires that this permit be posted conspicuously on site. It is recommended that the soil erosion permit be posted along with the building permit. 2. By the end of each workday, sweep or scrape up soil tracked onto the road. By the end of the next workday after a storm, clean up the soil washed off-site. 3. On a daily basis, inspect, repair, and/or replace silt fence and other required soil erosion controls. 4. Stock piled soils must be at least 15 feet from curb and sensitive features, such as lakes, streams, county drains, or wetlands, unless authorized by enforcement officer on approved plan. 5. Catch basin shall not be located within a driveway unless approved Drain Office engineer on the site plan. 6. Temporary control measures must remain in place and be maintained until permanent site stabilization is completed and the site is formally closed by the Drain Office. The site is closed when permanent erosion control measures (pavement, rock, established grasses, and other landscaping) are installed and grass has been established to at least three inches of growth with coverage greater than 90% of disturbed area. Permanant stabilization must be completed within 5 days after final grade. 7. Applicant is responsible for ensuring that earth disturbance on site remains within limits as indicated on approved site plan. Drain Office must be notifed of any modifications to the limit of earth disturbance. 8. After a site is closed, permanent erosion control measures are to be maintained by the property owner of record. 9. Enforcement staff may review and modify the approved soil erosion plan as needed throughout the construction period. APPLICANT TO COMPLETE AND SUBMIT THE FOLLOWING 1. A scaled site plan of 1:60 or less with the following and all other required information listed in Rule of Part 91 indicated on plan: - Legal description (Including all easements, township, section, and street address) - Location and proximity to lake, stream, county drain, wetland, or other regulated waters - Limits of earth disturbance - Drainage arrows and location of any drainage facilities - Location of catch basins - Existing and proposed final grade USGS elevations 2. Soil type: 3. Grade description: % slope 4. Excavated soils will be: Exported Used As Fill On Site Leveled On Site (If soil stays on site, indicate on site plan where soil will be leveled) Page 2

6 INGHAM COUNTY DRAIN COMMISSIONER PATRICK E. LINDEMANN 707 BUHL AVENUE P. O. BOX 220 MASON, MI (517) FAX (517) Part 91, Soil Erosion And Sedimentation Control Of The Natural Resources And Environmental Protection Act, Act 451 Of The Public Acts Of 1994, AS AMENDED Being Sections To Of The Michigan Compiled Laws. SOIL EROSION AND SEDIMENTATION CONTROL RULES R TO R RULES AND PROCEDURES OF THE INGHAM COUNTY DRAIN COMMISSIONER, Requirements FOR COMMERCIAL Soil Erosion And Sedimentation POLLUTION Control Permit # 5. Sequence and timing of project: (See also attached project scheduling and timing sheet) Installation of Erosion and Sediment Controls Excavation Rough Grade Final Grade Permanant Site Stabilization 6. Permanent site stabilization to be completed by: Builder Property Owner Other Applicantʼs Signature Date DRAIN OFFICE TO COMPLETE THE FOLLOWING 1. Review of sensitive features, severe slopes, and proximity to regulated waters. 2. Best management practices required for site (site plan to indicate location). Special note of BMPʼs for critical or sensitive features. Silt Fence Catch Basin Filter Bag Temporary Seeding Other Rock Access Drive Perpendicular Grading Sediment Stop Traffic Barrier Only Delivery Vehicles On Site Check Dam Buffer Strip Straw Bales Curb Undercut Catch Basin Filter Diversion Berm Rip Rap 3. Other: Page 3 Revised 1/1/2018

7 INGHAM COUNTY DRAIN COMMISSIONER PATRICK E. LINDEMANN 707 BUHL AVENUE P. O. BOX 220 MASON MI PH. (517) FAX (517) GENERAL CONDITIONS AND RESPONSIBILITIES TO COMMERCIAL SESC PERMIT In accordance with Rule 1709 promulgated under the authority of Part 91, Soil Erosion and Sedimentation Control, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, and in addition to the Rules and Procedures of the Ingham County Drain Commissioner and the information on the attached plan(s) and special conditions, the following general conditions apply to the earth change authorized by this permit: Design, construct, and complete the earth change in a manner that limits the exposed area of disturbed land for the shortest period of time. Remove sediment caused by accelerated soil erosion from runoff water before it leaves the site. Temporary or permanent control measures shall be designed and installed to convey water around, through, or from the earth change at a non-erosive velocity. Install temporary soil erosion and sedimentation control measures before or upon commencement of the earth change activity and maintain measures on a daily basis. By the end of each workday, sweep or scrape up sediment tracked onto roadways. Remove temporary soil erosion and sedimentation control measures after permanent soil erosion measures are in place and the area is stabilized. Stabilized means establishment of vegetation (90% coverage with three inches of growth) or the proper placement, grading, or covering of soil to ensure its resistance to soil erosion, sliding, or other earth movement. Complete permanent soil erosion control measures for the earth change within five calendar days after final grading or upon completion of the final earth change. If it is not possible to permanently stabilize the earth change, then maintain temporary soil erosion and sedimentation control measures until permanent soil erosion measures are in place and the site is stabilized. After a site is closed, permanent erosion control measures are to be maintained by the property owner of record. Stock piled soils must be at least 15 feet from curb and sensitive features, such as lakes, streams, county drains, or wetlands, unless authorized by enforcement officer on approved plan. Additionally, catch basins shall not be located within ten feet of a driveway unless approved by the Drain Office engineer on the site plan. Enforcement staff may review and modify the approved soil erosion plan as needed throughout the construction period. The property owner or legal representative of the property owner is responsible for the maintenance of soil erosion and sedimentation control measures and the permanent stabilization of the site. If the property is sold and legal transfer has not occurred, the original property owner is held responsible for all soil erosion and sedimentation control, permanent stabilization, and permit renewal as needed for compliance. The County Enforcing Agency may issue a Cease and Desist Order and shall revoke a permit upon finding a violation of the Act, these rules, an approved local ordinance, or that there is a violation of a permit or an approved soil erosion and sedimentation control plan. The Cease and Desist Order will be rescinded upon verification of site compliance, and submission of the application, permit fees, and a performance deposit. A minimum of $ as a cash performance deposit will be required for each subsequent permit issued over the following 12 months following a Cease & Desist Order. The Drain Commissioner s engineer will determine the commercial performance deposit amount. The amount of the performance deposit will increase with each Cease & Desist Order issued. Inspection fees for all site inspections following a Violation or Cease & Desist Order are as follows: Follow-up inspection to Violation Notice...$ Follow-up inspection to Cease & Desist Order...$ The permit holder is responsible for maintaining the validity of the permit throughout the duration of construction and ultimate stabilization of a site. Confirmation of adherence to approved grading plan and proposed final elevations will be required upon request of the Drain Commissioner s engineering staff. All outstanding fees, including performance deposit and inspection fee(s), must be paid prior to renewals or new permits being issued. I hereby acknowledge that I have read the above statement of responsibility under Part 91 and understand my responsibilities. I also acknowledge that I have received the MDEQ summary of the required permits under NREPA. Signature Date Revised 1/1/2018

8 Patrick E. Lindemann Ingham County Drain Commissioner PO Box Buhl Avenue Mason, MI Phone: (517) ! Fax: (517) Carla Florence Clos Deputy Drain Commissioner Paul C. Pratt Deputy Drain Commissioner David C. Love Chief of Engineering and Inspection Sheldon Lewis Administrative Assistant Letter of Authorization for Soil Erosion Permit I, the landowner, of property, parcel #, address:, authorize to secure a Soil Erosion and Sedimentation Control Permit for the earth disturbance on my property. Date: Landowner s Name: Address: City: State: Zip: Phone: Fax: Landowner s Signature Print Name Authorized Agent s Name: Address: City: State: Zip: Phone: Fax: Mobil Phone: Authorized Agent s Signature Print Name Revised 1/1/2018

9 NOTIFICATION OF EXISTING SOIL EROSION AND SEDIMENTATION CONTROL (SESC) PERMIT AND THE NEED TO TRANSFER PERMIT OBLIGATIONS Prospective Landowner(s): Mr./Ms.: Address: SUBJECT: SESC Permit No. Pursuant to Section 9112(5) of Part 91, SESC, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, please be advised that the parcel(s) you are purchasing is/are currently under the above referenced SESC permit issued by the Ingham County Drain Commissioner (Address: P.O. Box 220, Phone #: (517) ). A copy of that permit and approved plans are enclosed for your information. Please be advised that when the parcel(s) is/are transferred into your name(s), you assume responsibility for all permit obligations and conditions, including SESC plan requirements, and for any violations of the permit on the transferred parcel(s) that exist on the date the parcel(s) is/are transferred. Also, please be advised that if the earth change or SESC measures authorized by the above-referenced permit are altered or modified, a revised plan and a new SESC permit may be required. In addition, authorization to discharge storm water from this property has or has not been obtained (check appropriate box) under the National Pollutant Discharge Elimination System (NPDES) from the Michigan Department of Environmental Quality (MDEQ). If authorization was granted (Authorization No. ), you may have to obtain authorization on the parcel(s) you purchased. Landowners disturbing one or more acres that have a point source discharge to surface waters of the state are required to obtain NPDES authorization. Landowners disturbing from one to less than five acres with a point source discharge to the waters of the state have automatic NPDES authorization to discharge storm water once the SESC permit has been obtained. Landowners disturbing five or more acres with a discharge to the surface waters of the state are required to obtain NPDES authorization by submitting a Notice of Coverage (NOC) to the MDEQ. Note: NPDES storm water authorization must always be in the landowner s name and is predicated upon having an SESC permit in the landowner s name. Merely transferring the obligations of an SESC permit on a parcel within a common plan of development does not satisfy the requirement for having the SESC permit in the new landowner s name. If the parcel(s) you purchased requires NPDES authorization to discharge storm water, an SESC permit will have to be obtained from the SESC permitting agency referenced above prior to *Parcel Transfer

10 transferring the parcel(s) in your name(s). If the total disturbance on your parcel(s) exceeds five or more acres, you must submit an NOC, a copy of the SESC permit, site location map, and the appropriate fee prior to transferring the parcel(s) into your name to the MDEQ, Water Bureau, Permits Section, Constitution Hall, Second Floor North, P.O. Box 30273, Lansing, Michigan It is anticipated that the transfer of ownership will occur on. Please acknowledge receipt of this notification and your concurrence with the above-stated stipulations by countersigning below and returning it to me, the owner/permittee, at the address below by. This signed document must be submitted to the SESC permitting agency ten (10) business days prior to the transfer of the property. Disclaimer: This transfer form only fulfills the notification requirement regarding SESC permit obligations pursuant to Part 91 and the reauthorization, if appropriate, to discharge storm water from the site. It does not address the notification or permit requirements that may exist for any other federal, state, or local permits that may be associated with this property. Owner(s)/Permittee(s): Name(s): (print) (signature) Address: Phone: (date) Prospective Landowner(s)/Permittee(s): Name(s): (print) (signature) Address: (date) Phone: Enclosure Revised 1/1/2018 *Parcel Transfer

11 NOTIFICATION OF EXISTING SOIL EROSION AND SEDIMENTATION CONTROL (SESC) PERMIT AND THE NEED TO TRANSFER PERMIT Prospective Landowner(s): Name(s).: Address: SUBJECT: SESC Permit No. Pursuant to Section 9112(5) of Part 91, SESC, of the Natural Resources and Environmental Protection Act, 1994 PA 451, as amended, please be advised that the property you are purchasing is currently under the above-referenced SESC permit issued by the Ingham County Drain Commissioner (Address: P.O. Box 220, Phone #: (517) ). Upon transfer of the property to your name(s), the SESC permit will be transferred into your name(s). A copy of the existing permit and approved plans are enclosed for your information. Please be advised that when the property is transferred into your name(s), you assume responsibility for compliance with all SESC permit obligations and conditions, including plan requirements, and for any violations of the permit. Also, please be advised that if the earth change or SESC measures authorized by the above-referenced permit are altered or modified, a revised plan and permit modification will be required. In addition, authorization to discharge storm water from this property has or has not been obtained (check appropriate box) under the National Pollutant Discharge Elimination System (NPDES) from the Michigan Department of Environmental Quality (MDEQ). If NPDES authorization was granted (Authorization No. ), a written request to have the authorization changed to reflect new ownership must be made to MDEQ at the time the property is transferred. Requests must be submitted to the MDEQ, Water Bureau, Permits Section, Constitution Hall, Second Floor North, P.O. Box 30273, Lansing, Michigan If NPDES authorization to discharge storm water from the property has not been issued, notification to the MDEQ is not necessary. It is anticipated that the transfer of ownership will occur on. Please acknowledge receipt of this notification and your concurrence with the above-stated stipulations by countersigning below and returning it to me, the owner/permittee, at the address below by. This signed document must be submitted to the SESC permitting agency ten (10) business days prior to the transfer of the property. *Whole Property Transfer

12 Disclaimer: This document fulfills the notification requirement for transferring an SESC permit into a new owner s name pursuant to Part 91 and the reauthorization, if appropriate, to discharge storm water from the site. It does not address the notification or permit requirements that may exist for any other federal, state, or local permits that may be associated with the property. Owner(s)/Permittee(s): Name(s): (print) (signature) Address: Phone: (date) Prospective Landowner(s)/Permittee(s): Name(s): (print) (signature) Address: (date) Phone: Enclosures Revised 1/1/2018 *Whole Property Transfer

13 SESC PLAN REQUIREMENTS UNDER RULE 1703 COMMERCIAL DEVELOPMENT SITE PLANS (SESC Plan shall include but not be limited to all of the following) 1. Scaled map (1:60 or less) with north arrow 2. Legal description 3. Site location sketch with proximity to lake/stream (Give distances) 4. Limits of earth change 5. Predominant land features (Geographical & vegetative including wetlands) 6. Slope information (Contour intervals) 7. Soil information (Written description of soil types for land undergoing earth change) 8. Drainage & dewatering facilities (Drainage arrows) 9. Timing and sequence of proposed activity 10.Temporary SESC measures (Description and location for installation, maintenance, and removal of all temporary SESC measures, like silt fence, and indicate who is responsible for each) 11.Permanent SESC measures (Description and location for installation and maintenance of SESC measures, like grass, and indicate who is responsible for each) 12.Continued maintenance program for permanent SESC measures that remain after project completion (Indicate who is responsible for this)

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