Full Text
Cumberland County Planning Department P.O. Box 110, Cumberland, VA 23040 P: (804) 492-3520 F: (804) 492-9224 Revised December 2021 Page 1 of 4 Land Disturbing Permit Application Applicant shall complete all information as noted in blank spaces below. I hereby certify that I fully understand the provisions of the Cumberland County Erosion and Sediment Control Ordinance and Virginia Erosion and Sediment Control Regulations, along with the Virginia Stormwater Management Regulations, and that I accept responsibility for carrying out the Erosion and Sediment Control and Stormwater Management Plan for the above reference project. I further agree to comply with any additional requirements deemed necessary by the Cumberland County E&S Inspector. PROPERTY OWNER INFORMATION: APPLICANT INFORMATION: Phone Phone Mobile Mobile PROJECT INFORMATION: RESPONSIBLE LAND DISTURBER: Project TM sq. ft. Plan Prepared Plan Preparer’s Phone Plan Preparer’s Mobile Estimated Project Completion: RLD License ___________Expiration ---PAGE BREAK--- I further grant the right-of-entry onto this property, as described above, to the designated personnel of Cumberland County and the Commonwealth of Virginia for the purpose of inspecting and monitoring for compliance with the foresaid Ordinance. The following general statements shall apply to all permits: All projects shall conform to the Virginia Erosion and Sediment Control Handbook (VESCH), 1992 Edition and the Virginia Stormwater Management Handbook, Volumes I and II dated 1999, as amended and current Virginia Erosion and Sediment Control and Stormwater management Law and Regulations. This permit and approved set of plans must be kept on the work site and shown when requested. Before work is performed on-site the Cumberland County Erosion and Sediment Program Administrator must be notified (24 hrs. in advance) to schedule an on-site meeting. Applicant agrees to be responsible for any and all damages to any other installations already in place as a result of work covered by this permit. Applicant agrees to maintain the work in the manner approved upon its completion. The land-disturbing permit may be revoked should the Board of Supervisors or their designated agent determine that the project is not in compliance with the conditions of the approved plan. Applicant agrees to obtain all necessary permits and adhere to all regulations per Cumberland County Code and all other applicable state and federal agencies. A Virginia Stormwater Management Permit (VSMP) is required by state law if the total amount of disturbed area exceeds one acre in area. A VSMP permit for less than 1 acre of disturbance is needed if part of common plan of development (such as master plan for a rezoning request or a preliminary plat for a major subdivision). If such situation applies to your activity, please visit http://www.deq.virginia.gov or contact [PHONE REDACTED] for more information about VSMP permits. Please provide VSMP permit Date I, as applicant, certify that I have read and understand the above requirements of this permit. _________Initials Section 34-35 of the Cumberland County Erosion and Sediment Control Ordinance requires that a Bond or Surety be posted with the County in the amount determined by the plan-approving authority. Such Bond shall be conditioned to conform to any work and approved standards and specifications as specified in the approved Erosion and Sediment Control Plan. Final inspection of the project shall be made by the Program Administrator or designated agent. The release of any Bond is contingent upon the findings of such inspection. Release of the Bond shall occur within 60 days after the project site is deemed adequately stabilized by the Program Administrator. The amount of such surety is hereby set at A submittal is not complete until all of the following has been submitted: Completed application and all applicable fees paid; Minimum of 3 copies of the E&S plan (with calculations) stamped and sealed by a land planning professional; Completed Minimum Standards Checklist (must be completed and signed by plan preparer) AND ---PAGE BREAK--- Cumberland County Planning Department P.O. Box 110, Cumberland, VA 23040 P: (804) 492-3520 F: (804) 492-9224 Revised December 2021 Page 3 of 4 Completed Necessary Components Checklist (must be completed and signed by plan preparer) Certification of lot area to be disturbed (if single family residence, under one acre of disturbed land, and NOT in a subdivision) OR certification of completion of VSMP requirements. NOTE: Plan is reviewed by staff with the Peter Francisco Soil and Water Conservation District. Plan reviewer has 45 days to review a plan and return to the County with comments. In addition to the above, a land disturbing permit shall not be issued until the following has occurred: The E&S plan has been approved by Cumberland County; AND A performance bond, cash escrow, or irrevocable letter of credit in the amount listed above to complete the standards and specifications shown on the approved E&S Plan. FEES Plan Review Fees Erosion and Sediment Control plan review for residential use: $200.00 plus $50.00 per lot Erosion and Sediment Control plan review for commercial use or agricultural non-exempt: $300.00 plus $50.00 per acre Permit Fees Erosion and Sediment Control permit fee for residential use: $300.00 plus $150.00 per lot Erosion and Sediment Control permit fee for commercial use or agricultural non-exempt: $300.00 plus $50.00 per acre Inspection Fees Erosion and Sediment Control inspection fee for commercial use or agricultural non-exempt: 25 acres or less* $200.00 per month to be prepaid through completion date More than 25 acres but less than 100 acres* $250.00 per month to be prepaid through completion date More than 100 acres* $400.00 per month to be prepaid through completion date inspection fees after the proposed completion date regardless of project size $400.00 per month * All Applicants for commercial projects shall provide a project completion date. No refunds or prepaid fees will be given for early completion If a project for which a bond is required exceeds the project completion date provided by the applicant, the bond cannot be released until the additional inspection fees are paid and all requirements are met. Initials ---PAGE BREAK--- THIS PERMIT WILL EXPIRE ONE YEAR FROM DATE ISSUED. Name of Responsible Land Disturber (please print) Signature of Responsible Land Disturber Date Name of Applicant (please print) Signature of Applicant Date Name of Property Owner 1 (please print) Signature of Property Owner 1 Date Name of Property Owner 2 (please print) Signature of Property Owner 2 Date Name of Property Owner 3 (please print) Signature of Property Owner 3 Date OFFICE USE ONLY COUNTY E&S FILE ESTIMATED COMPLETION DATE: PLAN REVIEW FEE: DATE PAID: RECEIPT PERMIT FEE: DATE PAID: RECEIPT INSPECTION FEE: DATE PAID: RECEIPT SURETY AMOUNT DUE: DATE PAID: APPROVED: E&S Program Administrator Date Date ACTUAL PROJECT COMPLETION DATE: FILE CLOSED: SIGN SIGN SIGN SIGN SIGN