Fillable APPLICATION FOR A ZONING PERMIT (Village of Whitehouse)

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APPLICATION FOR A ZONING PERMIT (Village of Whitehouse)

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BROWSE VILLAGE OF WHITEHOUSE (OH) FORMS

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Revised 03/2018
APPLICATION FOR A ZONING PERMIT
The undersigned hereby applies for a Zoning Permit for the following use and or building, to be issued on the basis of the information
contained herein, including attached plot plans and drawings, all of which applicant says are true.
Subdivision: _____________________ Lot #____ Address of Parcel: ____________________
Owner: __________________________Phone #_________ Email: ______________________
Contractor: _____________________________________________ Phone #_______________
Address: _________________________________ Email: _____________________________
Lot size: ______’ x ______’ Type of lot: Inside Corner
Check all that apply: New dwelling Remodel Addition
Garage Shed Deck Other
Fill in all that apply:
Dwelling: # of Families ___ Square footage (including garage and basement) ________
Building size: ______’ x ______’ Height: ______ Stories: _____ Roof pitch______
Eave overhang ______ Construction value: $_______________
Remodel: Size of Area: ______________ Explain changes: ___________________________
Addition: Size: _____’x______’ Location: Front Back Side
Garage: Size: _____’x______’ Square footage: ________ Height: _____ Use: _________
Shed: Size: _____’x______’ Square footage: ________ Height: _____ Use: _________
Deck: Size: ____________________ Location: Front Back Side
Remarks: _____________________________________________________________________
By signing below, I understand that Whitehouse is required to obtain National Pollution Elimination System (NPDES)
general permit coverage for Municipal Separate Storm Sewer Systems under the purview of the Clean Water Act. I also
understand that I must comply with certain regulations as outlined in the attached letter dated December 27, 2016. I hereby
acknowledge that I have received a copy of the information and will abide by such regulations while working in
Whitehouse.
The undersigned states that this Application is true, accurate and complete with all required documentation. Whitehouse
relies on the completeness, relevancy, and accuracy of the Application for Zoning Permit. I have read the foregoing
application and agree. Any certificate issued upon a false statement of any fact, which is material to the issuance hereof,
shall be void.
Signature: ________________________________________
_____ Date: ______________________
Submitted by (Please Print): _______________________________________________
OFFICE USE ONLY: Date Received: _____________ Fee paid: ___________ Check #___________Receipt #__________
Revised 03/2018
Is a second water meter (for irrigation) needed: Yes ___ No ___ Second meter set-up and back flow device
can be purchased now or at a later date. Current price is $525.
Checks should be payable to Village of Whitehouse, in the amount of $2,425. Note: add $525 if purchasing a
second water meter set-up and an additional $450 if two street trees are required.
Zoning permit fee $ 50.00 Sidewalk permit fee $ 50.00
Storm sewer permit $ 25.00 Sanitary tap fee $1,100.00
Water tap fee $ 750.00 Street tree fee/per tree $ 450.00
Second meter & back flow $ 525.00 (if needed)
I, ___________________________ (Contractor) acknowledge receipt of one / two water meter set-up on
_______________________, 20___.
December 27, 2016
Dear Contractor:
In
July of 2016, the Village of Whitehouse was notified by Ohio Environmental Protection
Agency (OEPA) of the need to obtain National Pollution Elimination System (NPDES) general
permit coverage for Municipal Separate Storm Sewer Systems (MS4) as an urbanized area.
While the Village is in the process of obtaining coverage which will regulate storm water
discharges under the purview of the Clean Water Act, we would like to make you aware of
several changes which
you are presently required to comply with.
The Village of Whitehouse requirements for erosion and sediment control for small construction
sites are as follows:
1.
Existing vegetation shall be retained on idle portions of the building lot for as long as
construction operations allow. Clearing shall be done for active working areas only.
2.
Temporary seed (annual rye, oats, etc.) and/or mulch shall be applied to areas, such as
stockpiles, that are bare and not actively worked. This shall apply to areas that will not be
reworked for 14 days or more.
3.
Stockpiles excavated from basements shall be situated away from streets, swales and/or
waterways and shall be seeded or mulched as per item 2 above.
4.
Silt fence and/or wattles shall be provided and maintained in workable condition to
control and filter sheet flow runoff from the building lot.
It
shall not be constructed in
channels or areas of concentrated flow. Other sediment controls such as inlet protection
and sediment traps shall also be used and maintained as needed at the direction of the
inspector to control sediment runoff.
5.
Construction vehicle access to a lot shall be limited to one temporary access drive
consisting of gravel or crushed rock and shall be maintained in an acceptable condition.
6.
Mud tracked onto the street or sediment settled around curb inlet protection shall be
inspected for and removed daily or as needed to prevent accumulation. Accumulated
material shall be removed by mechanical means (i.e. shoveling, scraping, sweeping) and
shall not be washed off pavement or into storm drains.
6925 Providence Street . PO Box 2476 . Whitehouse, Ohio 43571
Phone 419-877-5383 . Fax 419-877-5635
whitehouseoh.gov
Page 2
December 27, 2016
7.
A dumpster for construction debris shall be onsite prior to commencement of
construction. All construction site debris shall be placed in the dumpster at the end of
every work day. The inspector may require a cover to ensure the items placed in the
dumpster remain.
8.
Onsite portable restroom facilities shall be required for each individual lot.
9.
The haul route utilized to the site shall be the safest and shortest route possible. All non-
weight restricted roads shall be utilized prior to utilizing weight restricted roads.
10.
Hauling of excavated or fill material shall be required to comply with Ohio General
Permit OHC000004.
As a Contractor for residential new construction, the Village of Whitehouse requires a letter from
the Developer of the subdivided property, stating the Developer is the Operator and the
responsible party for the Storm Water Pollution Prevention Plan (SWP3) for the sub-division
prior to requesting zoning approvals. The letter shall state that you, the contractor and your
subcontractors, are aware of the requirements of the SWP3 for the subdivision and the
requirements for the individual lot.
A site plan shall also be submitted showing the required Best Management Practices (BMPs) for
the individual lot. Required items specifically addressed shall be:
• Location of excavation
• Location of spoil pile
• Location of dumpster
• Location of stone/gravel entrance/exit drive, one per lot
• Location of onsite concrete wash area with silt fence
• Location of any curb drains/storm water drainage structures on the lot
• Location of restroom/portable toilet
• Direction of surface flow storm water off the building site and the body of water in which
it drains
Upon review of the site plan, the inspector may require additional control measures be
established and maintained for the individual lot such as silt screen and/or wattles.
If the Developer is no longer the Operator for the SWP3 the Contractor will be required to file
for Individual Lot Notice of Intent (NOI) coverage through OEPA for Stormwater. Proof of
obtaining coverage, or that coverage is presently in place, will be required prior to construction
activity. NOI forms can be obtained at epa.ohio.gov/portals/35/storm/ILOT instructions.pdf.
6925 Providence Street . PO Box 2476 . Whitehouse, Ohio 43571
Phone 419-877-5383 . Fax 419-877-5635
whitehouseoh,gov
I •
Page 3
December 27, 2016
With this coverage, you as the contractor/lot owner, will be required to draft an individual lot
SWP3 and have the plan available on the job site for review upon request. Guidance for the
development of your individual lot SWP3 can be found at epa.gov/sites/production/files/2015-
12/documents/cgp small lot swppp brochure-508 0.pdf
A copy of the Small Residential Lot Stormwater Pollution Prevention Plan Template is available
on the Village website at whitehouseoh.gov/wp-content/uploads/2016/08/Small-Residential-Lot-
Stormwater-Pollution-Prevention-Plan-Template.pdf
All BMPs required items in the individual lot site plan shall be in place and operational prior to
commencement of construction activities. Any items found to be out of compliance will require
immediate con-ection. Refusal to comply with Village of Whitehouse erosion and sediment
control requirements may result in fine(s) being imposed and/or "Stop Work" orders for
the individual lot construction sites.
Additional information on compliance can be found at epa.ohio.gov/dsw/ston-n/technical
guidance.aspx
Additional information on stormwater requirements and coverage under Ohio General
Construction Permit (OHC000004) - Construction Site Storm Water, is available at epa.ohio.
gov/dsw/ston-n/index.aspx#116075650-notice-of-intent-applications
A copy of this letter with the above links is posted on the Village of Whitehouse web site
whitehouseoh.gov/departments/public-service.
If you have questions or need further clarification, please feel free to contact me. Thank you for
your cooperation.
Respectfully,
Steven P Pilcher
Director of Public Service
6925 Providence Street. PO Box 2476 . Whitehouse, Ohio 43571
Phone 419-877-5383 . Fax 419-877-5635
whitehouseoh.gov
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APPLICATION FOR A ZONING PERMIT (Village of Whitehouse)

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Completed 17 July 2020

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