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«CONSTRUCTION ACTIVITY APPLICATION Sites within Regulated Area and disturbing one-half (1/2) acre or more For Official Use Only Date Received: ...»

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BERKELEY COUNTY STORMWATER MANAGEMENT PROGRAM

CONSTRUCTION ACTIVITY APPLICATION

Sites within Regulated Area and disturbing one-half (1/2) acre or more

For Official Use Only

Date Received: ________________ Berkeley County Stormwater Management Program

APPROVED

Application No: _______________ Stormwater Management Construction Activity Application Application No:___________________________________

Approval Date:____________________________________

Approved by: _____________________________________

I. Owner Information Owner (Company or person):___________________________________________________________________________

Contact Person:____________________________________________________ Company EIN: __ __ - __ __ __ __ __ __ __ Address: ___________________________________________________________________________________________

City:____________________________________________________________________ State: _______ Zip:__________ Phone: (Day) __ __ __-__ __ __-__ __ __ __ (Mobile) __ __ __-__ __ __-__ __ __ __ (Fax) __ __ __-__ __ __-__ __ __ __ Email address:_______________________________________________________________________________________

II. Operator Information Company or person:__________________________________________________________________________________

Contact Person:____________________________________________________ Company EIN: __ __ - __ __ __ __ __ __ __ Address: ___________________________________________________________________________________________

City:____________________________________________________________________ State: _______ Zip:__________ Phone: (Day) __ __ __-__ __ __-__ __ __ __ (Mobile) __ __ __-__ __ __-__ __ __ __ (Fax) __ __ __-__ __ __-__ __ __ __ Email address: ______________________________________________________________________________________

III. Contractor Information Company or person:__________________________________________________________________________________

License #:__________________________________________________________________________________________

City:____________________________________________________________________ State: _______ Zip:__________ Phone: (Day) __ __ __-__ __ __-__ __ __ __ (Mobile) __ __ __-__ __ __-__ __ __ __ (Fax) __ __ __-__ __ __-__ __ __ __ Email address: ______________________________________________________________________________________

IV. Plan Preparer Information Plan Preparer: ___________________________________________________________ S.C. Registration #: __ __ __ __ __ Company/ Firm: _________________________________________________________________ S.C. COA #: __ __ __ __ Mailing Address: ____________________________________________________________________________________

City:____________________________________________________________________ State: _______ Zip:__________ Phone: (Day) __ __ __-__ __ __-__ __ __ __ (Mobile) __ __ __-__ __ __-__ __ __ __ (Fax) __ __ __-__ __ __-__ __ __ __ Email address: ______________________________________________________________________________________

Adopted September 1, 2008 V. Project Information A. Project Name: ______________________________________________________________________________________

Location (street address, nearest intersection, etc.): ____________________________________________________________

_____________________________________________________________________________________________________

Tax map # (list all):_____________________________________________________________________________________

_____________________________________________________________________________________________________

Disturbed area (to the nearest tenth of an acre): __ __ __ __ __. __ Total area: __ __ __ __ __. __ Impervious area: __ __ __ __ __. __ B. Is this project part of a Larger Common Plan for Development or Sale (LCP)? Yes No LCP/Overall Development Name: _________________________________________________________________________

Check here if this is the first phase.

Previous state permit/file no.? __ __-__ __-__ __-__ __ __ Previous NPDES coverage number: SCR10 __ __ __ __

C. Type of Construction Activity (check all that apply):

Commercial Residential: Single-family Linear (Roads, utility lines, etc.) Institutional Residential: Multi-family Site Preparation (No new impervious) Industrial Re-development Other:_________________________

VI. Waterbody Information A. Nearest receiving waterbody(s): _______________________________ Distance to this waterbody (feet):_____________

Next/Nearest named receiving waterbody(s):________________________________________________________________

–  –  –

C. Special Protection Areas*

1. Are there any flooding problems downstream of or adjacent to this site? Yes No If yes, see attached instruction.

2. Are any portions of the site located in a designated floodplain? Yes No If yes, what are the FIRM Numbers?____________________________________________________________________

3. List the nearest DHEC water quality monitoring station(s) [WQMS(s)] to which stormwater (SW) discharges will drain and the corresponding waterbody(s). ____________________________________________________________________





3.1. Is this WQMS listed on the most current 303(d) List for Impaired Waters? Yes No a. If yes for (3.1), list the impairment(s). ____________________________________________________________

b. If yes for (3.1) will SW discharges from your site contain the pollutant(s) of impairment? Yes No c. If yes for (b) will use of the proposed BMPs ensure that the site’s discharges will not contribute to or cause further water quality standard violations? Yes No

–  –  –

VII. Signatures and Certifications A. One copy of the stormwater plan, all specifications and supporting calculations, forms, and reports are herewith submitted and made a part of this application. I have placed my signature and seal on the design documents submitted signifying that I accept responsibility for the design of the system. Further, I certify to the best of my knowledge and belief that the design is consistent with the requirements of the Berkeley County Stormwater Management Ordinance and the Berkeley County Stormwater Design Standards. (This should be the person identified in Section IV)

–  –  –

B. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.

Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.

I hereby certify that all construction and associated activity pertaining to this site shall be accomplished pursuant to and in keeping with the terms and conditions of the approved plans. I also certify that a responsible person will be assigned to the project for day-to-day control. I hereby grant authorization to Berkeley County the right of access to the site at all times for the purpose of on site inspections during the course of construction and to perform maintenance inspections following the completion of the land-disturbing activity.

–  –  –

** In such cases where an operator signs the certification, a copy of the maintenance agreement between the owner and operator as required by the Stormwater Management Ordinance must be submitted with this application.

Berkeley County Stormwater Management Program – Construction Activity Application Adopted September 1, 2008 Instructions

Completing the Application:

You must type or print legibly. You must include the original, signed application form, one copy of the stormwater plan, and one copy of all other supporting documentation with the initial submittal. A checklist of all the documents necessary to obtain Construction Activity Application approval is available online.

Who Must Submit an Application:

Any construction project located within “Regulated Area” as defined in the Stormwater Management Ordinance and disturbing one (1) acre or more unless exempted in the Ordinance and/or Manual.

"Regulated Area" is defined in the Stormwater Management Ordinance as “the boundaries of Berkeley County's urbanized areas as determined by Decennial Census Data from the United States Bureau of the Census. Regulated Area also includes any portion of the County that is so designated by Berkeley County Council. The Regulated Area designated by Berkeley County Council coincides with the area defined as "Service Zone 1" by the "Transportation Impact Fee Ordinance for Unincorporated Berkeley

County" (Ordinance No. 06-11-75)”. The Regulated Area can be viewed from Berkley County Website:

http://gis.berkeleycountysc.gov/disclaimer.html GIS Mapping → GIS Internet Mapping (MS4 Regulated Area)

Projects located in the Berkeley County Regulated Area submit to:

Berkeley County Engineering 1003 Highway 52 Post Office Box 6122 Moncks Corner, S. C. 29461-6120 843.719.4127 I. Owner Information The official or legal name of the owner shall be listed. If the owner is a company, then a Permit Contact person shall be listed. This can be someone other than the person that has signatory authority for the company. All correspondence regarding this permit application will be sent to Permit Contact at the address listed.

Owner is defined in the Stormwater Management Ordinance as the “property owner, or any person who acts in his own behalf, that submits an application for approval to disturb land or vegetation or encroachment and the person, if so designated by default or on legal documents, as the responsible party for maintenance of a stormwater system(s) and facility(s)”.

The Company EIN is the Employer Identification Number as established by the U.S. Internal Revenue Service.

II. Operator Information The official or legal name of the operator should be listed. If the operator is a company, then a Permit Contact person shall be listed. This can be someone other than the person that has signatory authority for the company. All correspondence regarding this permit application will be sent to Permit Contact at the address listed.

Operator is defined in the Stormwater Management Ordinance as the “the person who is operating the property, including an operator or person who is in charge of any activity related to land disturbance, construction or post construction stormwater quality or quantity”.

The Company EIN is the Employer Identification Number as established by the U.S. Internal Revenue Service.

III. Contractor Information The name of the Company shall be listed.

The Company License # is the License number as established by the State.

IV. Plan Preparer Information Enter the name and registration number of the stormwater plan preparer. S.C. COA is the company’s S.C. Certificate of Authorization. Enter N/A for S.C. COA if the firm does not have a COA or the preparer is an individual. If an email address is entered, the County Engineer may contact the plan preparer via email.

Note: Typically, the plan preparer must be an engineer licensed in the State of South Carolina. For certain construction activity, the plan preparer may be someone other than a licensed engineer. However, this must be approved in advance by the County Engineer.

Berkeley County Stormwater Management Program – Construction Activity Application Instructions Adopted September 1, 2008 V. Project Information A. The Project/ Site Name should be a unique or distinguishing name (e.g., not Proposed Subdivision). The Department should be notified in writing if the Project/ Site Name changes.

County: If the project is in multiple counties, list all counties and indicate in which county the majority of the project will be.

The total and disturbed areas should be rounded to the nearest tenth of an acre. For subdivisions, if the exact build-out is not known, the disturbed area can be estimated using the following equation: Disturbed area = 2(Maximum Footprint of House)(# of lots) + Road/ Right-of-Way areas + Other easements/ disturbance. Please note that the County must be notified if the actual disturbed area is greater than the disturbed area listed on the application.

B. Institutional includes schools and other publicly owned projects, except linear projects. Site Preparation includes clearing, grubbing, and grading only; no new impervious areas shall be proposed if this activity type is checked.

VI. Waterbody Information A. The nearest receiving waterbody is the nearest waters of the State to which the site’s stormwater will discharge. If this waterbody is unnamed, then provide a description that references the nearest, named waterbody (e.g., tributary to Grove Creek). If the site’s stormwater discharges to multiple waterbodies, then list all such waterbodies and attach additional sheets, if necessary.

C. Special Protection Areas: If yes for (2), then the extent of the flooding problems and the effect of this project on those problems must be explained in the checklist under Project Narrative. For design criteria, see checklist under Special Protection Areas.

VII. Certifications A. The same licensed professional must sign and seal the application, drawings, calculations, and supporting documentation.

B. A person with signatory authority for the project owner/ operator must sign the application. The plan preparer cannot sign the application for the project owner/ operator. The plans, all reports, including monthly reports, and any information requested by the Engineering Department must be signed by a person with signatory authority for the project owner/ operator or a duly authorized representative.



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