Fillable Erosion Control Permit Application- 2019 Fillable (City of Tualatin)

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Erosion Control Permit Application- 2019 Fillable (City of Tualatin)

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The Erosion Control Permit Application- 2019 Fillable (City of Tualatin) form is 2 pages long and contains:

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  • 22 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Tualatin

BROWSE CITY OF TUALATIN (OR) FORMS

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Project Name:
Project Address:
Project Tax Map & Lot No:
Project Site Size:
Acres
Disturbed Work Area:
Acres
Project Site Runoff Drains to
(check all that apply):
Catch Basin
Ditch
Pipe
Surface Water*
*Surface water: river, creek, lake, stream, wetland, pond, etc.
Project is on
(check all that apply):
Private Property
Public Property
Property Owner Name:
Property Owner Address:
Property Owner Signature:
Applicant Name:
Applicant Address:
Applicant Phone Numbers:
Applicant Signature:
General/Excavation Contractor Name:
General/Excavation Contractor Address:
Gen/Exc. Contractor Phone Numbers:
CCB #:
24 Hr/After Hrs Phone Number:
Contact Person, Title:
PERMIT FEE:
$
PLAN CHECK FEE:
$
TOTAL:
$
EROSION CONTROL
& SEDIMENTATION:
PERMIT APPLICATION
PW Permit No:
EC Permit No:
Date Received:
Date Paid:
Receipt: Number:
Date Issued:
By:
CITY OF TUALATIN
18880 SW Martinazzi Avenue
Engineering Division
Tualatin, OR 97062
CWS Inspection Hotline: (503) 681-4444
Fax: (503) 692-0147
www.tualatinoregon.gov
Single Family Residence
Erosion Control (Disturbing under 1 acre)
1200-CN (Disturbing between 1-5 acres)
1200-C (Disturbing over 5 acres, DEQ required)
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Note: For projects one acre or larger in size, a NPDES 1200-CN is required and shall be submitted as
part of this permit.
For projects five acres or larger in size, a NPDES 1200-C is required and shall be submitted as
part of this permit.
Location & Address where
spoils leaving site will be taken:
Permits may be required
EROSION / SEDIMENTATION CONTROL (ESC) MEASURES
Minimum ESC Requirement During Construction:
Minimum Requirements Following Construction:
Sedimentation Facilities
Stabilize Exposed Surface
Stabilized Construction Entrance
Remove & Restore Temporary ESC Facilities
Perimeter Runoff Control
Clean & Remove All Silt & Debris
Clearing & Grading Restrictions
Ensure Operation of Permanent Facilities
Cover Practices
Other:
Construction Sequence
Other:
This plan for erosion control was prepared and submitted in accordance with Clean Water Services'
Design and Construction Standards. This erosion control plan has construction notes complete:
including, but not limited to, emergency phone number, phasing schedule, current details, and staging for
installation and removal of erosion control measures.
I have read and will comply with the above and will construct and maintain ESC measures as necessary
to contain sediment on the construction site. I understand that failure to comply is a violation of Tualatin
Municipal Code Chapter 3-5.
M:\Engineering\Forms\Erosion Control Permit\Erosion Control Permit - App
Revised 08/2019
EROSION CONTROL
& SEDIMENTATION:
PERMIT APPLICATION
Applicant Signature:
Date:
Owner Signature:
Date:
Engineering/Building
Division Approval:
Date:
CITY OF TUALATIN
18880 SW Martinazzi Avenue
Tualatin, OR 97062
CWS Inspection Hotline: (503) 681-4444
FAX: (503) 692-0147
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Erosion Control Permit Application- 2019 Fillable (City of Tualatin)

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Completed 16 July 2020

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