TOWN OF CLAYTON
Public Services – Engineering Division
111 E. Second St., P.O. Box 879
Clayton, NC 27528
Phone: 919-553-5002
Fax: 919-553-1720
December 2020
EROSION CONTROL PERMIT TRANSFER REQUEST
REQUIRED INFORMATION FOR APPROVAL
SUCCESSOR-OWNER NAME ______________________________________________
MAILING _______________________________________________________________
ADDRESS_______________________________________________________________
GRADING CONTRACTOR ________________________________________________
MAILING_______________________________________________________________
ADDRESS ______________________________________________________________
PHONE_________________________________________________________________
TOWN OF CLAYTON PROJECT # __________________________________________
NAME OF PROJECT ______________________________________________________
PROJECT LOCATION _____________________________________________________
TOWN FINDINGS
1. The plan holder is one of the following:
A deceased natural person
A dissolved partnership, LLC, Corporation or other business association
A person lawfully and finally divested of the title to property
2. Successor-owner holds title to property: ___ Y or ___ N
3. Successor-owner is sole claimant to right to engage in activity: ___ Y or ___ N
4. Substantial change to permitted activity: ___ Y or ___ N
I, , successor-owner, shall comply with the terms and conditions of the permitted
plan once the transfer has been approved. I further agree to indemnify and save harmless the Town of Clayton from
any liability damages or losses resulting directly or indirectly from the land disturbing activities described hereon. I
acknowledge that violation of erosion control regulations will result in civil penalties of up to $5,000 per day.
___________________________ _______________ ______________________
Signature Date Phone#
click to sign
signature
click to edit
![]()
