Fillable EXCAVATION APPLICATION (Town of Allenstown)

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EXCAVATION APPLICATION (Town of Allenstown)

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TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 1 of 7
EXCAVATION APPLICATION
Pursuant to RSA 155-E, the following application must be submitted to the regulator,
the Allenstown Planning Board, to obtain an excavation permit. Prior to issuance of a
permit, the regulator shall determine that the provisions of RSA 155-E, the Town
Excavation Regulations, and any other applicable regulations or ordinances are met.
Applicants qualifying under the exemption provisions of RSA 155-E:2 and filing the
reclamation plan pursuant to RSA 155-E:5 are to utilize this form noting the intent of
this application.
*ALL APPLICATIONS ARE TO BE SUBMITTED ELECTRONICALLY TO:
ADMIN@ALLENSTOWNNH.GOV
PART 1. APPLICATION TYPE
Please check the appropriate Planning Board action:
Excavation Permit
Reclamation Plan Submittal
Excavation Permit Renewal
PART 2. PROJECT INFORMATION
Please type or print clearly.
Date
Project Name
Site Address or Location
Tax Map Number
Tax Lot Number
Zoning District(s)
Zoning Overlay District(s)
Special Use Permit
Required?*
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 2 of 7
PART 2. PROJECT INFORMATION, continued
ZBA Variance or Special
Exception Required?**
Total Acres
Total Frontage
Purpose of Plan
*If special use permits are required, applications will need to be submitted with this
Excavation Application.
**If ZBA variances or special exceptions are required, the ZBA Notices of Decision must
be submitted with this Excavation Application.
PART 3. APPLICANT INFORMATION
The applicant is usually a professional (surveyor, engineer, developer,
architect, attorney, etc) representing a property owner before the Board.
This is to certify that the information contained in this application is
complete and true to the best of my knowledge.
Name
Company
Address
Phone Number
Email (required)
Fax
Signature
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 3 of 7
PART 4. PROPERTY OWNER INFORMATION
If the applicant (above) will be representing the property owner before
the Planning Board, please submit a notarized letter of authorization
from the property owner(s). This is to certify that the information
contained in this application is complete and true to the best of my (our)
knowledge.
Owner 1 Owner 2
Name(s)
Address
Phone Number(s)
Email(s)
Signature(s)
Owner 3 Owner 4
Name(s)
Address
Phone Number(s)
Email(s)
Signature(s)
PART 5. OTHER APPLICATION REQUIREMENTS
The following items are required for a complete application. The Board
will make a determination at its next regular meeting, after the project
has been publicly noticed, whether the application is complete.
Certified Notification Lists
Notarized Letter of Authorization
Project Narrative Letter describing the project in detail, existing conditions, etc.
Waiver requests in writing, if applicable.
Application and Escrow Fees (please refer to the appropriate checklist for fee
schedule(s))
Five full sets of 22”x34” plans, folded to 8.5”x11” with original signatures and
stamps (see Part 6. for required components)
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 4 of 7
PART 5. OTHER APPLICATION REQUIREMENTS, continued
Copies of the excavation plan reduced to 11” x 17”, folded to 8.5”x11”, as
follows:
*15 for the Planning Board
*10 for Technical Review Committee and other Town Departments
*1 copy per each certified notice
5 copies of a reclamation plan (see Part 7. for components)
Copies of any drainage, hydrologic, or other studies and associated plans if
available
Copies of any local, State, Federal or other applications (or permits if granted)
including Comprehensive Shoreland Protection Act, NH DES Dredge and Fill, NH
DOT Access, State Pit Agreement, Army Corps of Engineers , etc
PART 6. EXCAVATION PLAN COMPONENTS
The excavation plans submitted to the Board shall have the information
outlined in the Site Plan Review Regulations (see separate Site Plan
checklist) and the following:
Existing topography
Limits of excavation
Excavation depth (excavated topography)
Total area of excavation in acres
Access road(s) and intersection with town or state highways
Vegetation buffer
Distances from excavation limits to property lines
Schedule of excavation volumes; phasing of excavation (areas and dates)
Test pit groundwater elevations
Topsoil storage area
Drainage improvements (if necessary)
Photographs of existing conditions
A list of proposed equipment
Location of any gravel to be stockpiled
An estimate of the number of trips per day from site
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 5 of 7
PART 7. RECLAMATION PLAN COMPONENTS
The reclamation plans submitted to the Board shall have the information
outlined in the Site Plan Review Regulations (see separate Site Plan
checklist) and the following:
Reclaimed topography
Soil conditioning specifications
Seeding and mulching specifications
Plant materials/quantities/sizes
Phasing of reclamation (areas and dates)
Sections showing existing, excavated and reclaimed topography
PART 8. HAULING INFORMATION
The following information shall be submitted to the Board:
Routes to be utilized
Frequency of truck traffic over routes.
Size and weight of trucks used.
PART 9. FINANCIAL GUARANTEE
A financial guarantee shall be required for reclamation prior to the
issuance of an excavation permit. The amount shall be determined by the
regulator.
PART 10. PERMIT
An excavation permit will be valid for a period of one (1) year. An
application for permit renewal must be submitted to the regulator by the
owner if excavation is to be continued beyond the termination date. The
renewal application must identify and adjust all information contained in
the original application that is no longer effective for the renewal period.
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 6 of 7
PART 11. ESCROW BALANCES AND RETURNS
All applications for excavation require a positive balance in escrow accounts set up by
the Town which are used for engineering, consulting, and legal fees. Along with
application fees, an escrow check will be supplied by the applicant or property owner(s).
The property owner(s) acknowledges that when escrow funds are depleted, all Town
work on the project will stop until the fund is replenished. The Town will notify the
applicant, on behalf of the property owner(s), when the escrow balance is low.
In the review of applications, the Planning Board may contract with consultants to
review all or portions of any application. This review shall be at the applicant’s expense.
The Planning Board, at its discretion, may request an applicant to prepare special studies
at the applicant’s expense, or contract with a consultant to perform these studies at the
applicant’s expense.
If an escrow balance is in the negative, the property owner will be invoiced by the Town
to bring the balance into compliance. The project will not receive final approval without
a $0 balance or positive balance in the project’s escrow accounts. Unused project
escrow balances will be returned within 90 days of plan denial or plan registration to
ensure that outstanding invoices from consultants have been paid. You may attach
additional sheets if there are more than four (4) owners.
TOWN OF ALLENSTOWN EXCAVATION APPLICATION
2/2012 Page 7 of 7
Property Owner Name
PRINT
Date:
Signature
Property Owner Name
PRINT
Date:
Signature
Property Owner Name
PRINT
Date:
Signature
Property Owner Name
PRINT
Date:
Signature
Escrow balances are to be returned to (one name/address only):
Name
Address
As the applicant for this excavation permit, I, by signing below, acknowledge that I have
read both RSA 155E and the Allenstown Excavation Regulations. Additionally, I
understand any penalties associated with violating applicable state and local laws
pertaining to excavation operations.
_______________________________________________________________________
Signature Printed Name Date
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Completed 9 February 2021

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