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1. The size, finished and existing slope, and (City of Murray)

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BROWSE CITY OF MURRAY (KY) FORMS

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APPLICATION FOR CITY OF MURRAY, KENTUCKY PERMIT NO._________
LAND DISTURBANCE PERMIT OFFICE OF STORMWATER MANAGEMENT
I. LOCATION OF PROJECT NAME________________________________________________________
BUILDING LOCATION_____________________________________________________________
OWNER_________________________________ADDRESS_____________________
IMPORTANT - Applicant to complete all items
1. The size, finished and existing slope, and location of any cuts or fills.
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
2. A general description of the predominant soil types to be disturbed as indicated by the area soil
and water conservation district or other reliable resources.
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
3. The general location and size of the land area to be disturbed and the extent to which the
vegetation and topsoil will be removed.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
4. The general location, volume and type of soil or other materials to be used for fill in areas other
than the roadway.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
5. Location and description of existing natural features on the site such as contours, vegetation,
streams, and all other drainage.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
6. Measures that will be taken to contain the sedimentation to the subject property, both during
an after construction.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
7. Best Management Practices that will be installed to promote Stormwater Quality during and after construction
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
SUBMIT
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8. The approximate length of time that specific portions of the proposed development will lie unvegetated,
including the approximate date it will be disturbed and the approximate date it will be reseeded
or replanted.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
9. The type of plant material that will be planted, the approximate time frame for planting and
the persons who will be responsible for the planting.
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
SITE PLAN AND OTHER REQUIREMENTS
Every application for a soil erosion control permit submitted to this office shall be accompanied
by a site plan drawn to reasonable accuracy showing the following:
1. Lot boundaries, existing buildings, parking lots, etc.
2. Where silt fencing, sediment ponds, or other erosion control devices will be placed.
3. Street number and name
4. Subdivision and lot number
5. North arrow.
6. Any information required by the Office of Stormwater Management.
NOTE: Any land disturbance at or above 1 acre will require the DOW KYR10 Permit coverage along with
additional submittals including a SWPPPlan, a SWQPlan and ESCPlan to the City of Murray for review.
IDENTIFICATION
1. Name of Owner or Lessee Address Telephone No.
____________________________________________
____________________________________________
2. Name of Contractor and Erosion Address Telephone No.
and Sediment Control Inspector
____________________________________________
____________________________________________
3. Name of Architect or Address Telephone No.
Engineer
____________________________________________
____________________________________________
I hereby certify that I have reviewed all information in this document and agree to conform to all applicable laws
of the jurisdiction.
Signature of Applicant Title Application Date
Permit Number __________________ Permit Issued ________________________, 2_______
Approved By: ____________________________________
STORMWATER MANAGEMENT
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1. The size, finished and existing slope, and (City of Murray)

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Completed 14 July 2020

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