Carbon Conservation District

E&S Application

EROSION AND SEDIMENTATION CONTROL APPLICATION

This application page must be completed and sent with your plan submittal, and accompanied by the required fee, plans and narrative for erosion and sedimentation control reviews. All plans and drawings submitted that are larger than letter/legal size must be folded.  No rolled plans or drawings will be accepted.  The District allows 30 days for the review of a project. 

  

Municipality_____________________________Zoning Classification_____________________

 

Location/Development__________________________________________________________

 

Total Parcel Area Acre(s)__________________Total Disturbed Acres_____________________

 

Landowner/Applicant____________________________Telephone#______________________

 

e-mail:___________________________________ Fax#_______________________________ 

 

Address______________________________________________________________________

 

_____________________________________________________________________________

 

Plan Designer:_________________________________Telephone#________________________

 

Address______________________________________________________________________

 

e-mail:____________________________________Fax#   ______________________________

 

The undersigned agrees to comply with all requirements of Pennsylvania DEP Title 25 Chapter 102, Erosion and Sedimentation Control Rules and Regulations, and further agrees to obtain all necessary federal, state, county and local permits associated with subject project.

 

______________________________________________       __________________

 Signature of Landowner/Applicant or Agent                            Date

 FOR DISTRICT USE ONLY:

Name of Project______________________________________

 

Application #________________________________________

 

Required Fee:________________________________________

 

Date Received:_______________________________________