NCC241049_MODIFICATION Supporting Doc (LOT 55)_20240528 (2)

B"ceA6 Stuart Munidpal Building
■ too E.First 51reet
r Single-Family Dwelling ❑weis.4m WinsmnSalem,NC 27101
Field P.Q Box 2511
Erosion Control P e r rn i t Application Operations 1Mn tonSalem. NC 27102-2511
Please use this form when the Developer and Builder are not the same Phone:311 or t336)747-7453 financially responsible party/person and will be less than one(1)acre of Fax:[phone]e2
land disturbance on any one(1)lot.
Loos)to be Developed Information
Sile Address: G e(3 cot d uvcjt-r Te mace S{ sd�rr�, yc, z-s-:;2
Subdivision Name: (mil es
Anticipated Dates of Conslructior Activity: Start ¢-1 - a 4 Completion: a'a �- �✓�
—Complete the LOT INFORMATION TABLE for each lot to be developed;ensure that the appropriate drainage pattern type is
denoted. Attach a corresponding,existing platted survey for each lot with your application,please. If not,your permit
application may not be accepted for review.
Financially Responsible ParttylPerson
Name: Ly,1 �-G G
Address: 1 L o�c6 �r�F E t✓ rr�
CitylState/Z p: LS Office Phone:
Mobile Phone: 33�'314-8/93 Email Address: t0t1(•Ctv4'/f7Y_i�3 ,I wt f1,tvu(F'e. cant
My signature hereto signifies i am the owner1financially responsible party for job site compliance with the Erosion Control Ordinance
as outlined in Chapter,Sector 8.4 of the Unified Development Ordinances(UDO)of the City of Winston-Salem/Forsyth County or
Article IV of the UDO of the Village of Clemmons,Town of Lewisville,or Town of Walkertown.I hereby acknowledge that the Best
Management Practices annotated on the allached sketch plan must be properly installed and maintained to retain soil within the
constructed let.
I understand that ff the total disturbed area for any reason becomes greater than one acre on any one(1)lot,a professionally designed
and sealed Erosion Control Plan will be required to be submitted and approved before the start of the land disturbing activity on the lot.I
further acknowledge that City Inspection's staff may refuse to make building inspections and the Erosion Control Division may issue
Notices of Violation,Stop Work Orders and/or Civil Penalty Assessments for failure to comply with Erosion Control requirements.
Wo
Print Name of Financially Responsible Person Signature of Financially Responsible Person
TO BE COMPLETED BY CITY STAFF ONLY:
Date of Application Submittal: u
Permit Number.

Date: 3_19--� - —
PAGE 1
WINSTON-SALEMIFORSYTH COUNTY STANDARD SEDIMENT AND NO ES 1ot4APPinlln,ewi, T of 100 e ofrNT
t Thie
EROSION CONTROL PLAN FOR SMALL RESIDENTIAL LOTS md"aualenlperarwp0we*195
2 A viratdy map ehoft a,e teumafles IN Me pry and access to the site is to
-.. - ember be shorn an this atmidard 0-Or 10 aowmpww this standard plan.
TABLE OF CONTENTS 3 1lbd"e W0,pave--9P-°"e0 M Will B,el;nbofDiSWIlb-ce
(LOD)is to accompany this FlandM plan The LOD II Ma,kb.aces,o
Page measures.staying areas and Am"sat illelrwoM d"W.
1. Title Sheet 1 4 LOU are'T,n,~.or at final Wade Mole rA&V l 0 fdl sI I M ton has already,
gmrfed or meal graatny rs nob 0
2. Lot Information Table Z 5 The property does notaw*F nW eftMW,:r_a .e w,Mu,Iao feet e(the
3. Typical Individual Lot Layout With 3 . lots
-- ------ .^ 6, Tne site rt not localed in ray,QUOty V',,tar Zar
On,sfte-hipe Or eQllpff0d wwdr m W agor a
Curb and Gutter - �+ - f 7 No dlschatyes are ammm w dptidd Z*t
�+, l �' 8,
4. Typical Individual Lot Layout With 4 �+ - s TN5&te-wyesnyw,;wrnamm„ ensp�l �
_ 10.All disturbed areas rot bLA VWX be pomaed vwc,pefmanen.gaarmd carer.
Roadside Ditches _ -,�� 1 "pP"
_ �-'. A � 11.As a Aprr 1,2012,a119 Mllatapply otitis at de4WeWWNCG01(Or 91e
S. NCG-01 Self-Inspection s �• NCGO1 pemrL ilapplirabre.
6. NCG-01 Ground Cover&Material 6 12 The Aaaro+arAu"XA*le. waMerWiae*.ra —on oonw
plan to be prepared wW wlbeelbd Faroe 15 day resin.cycle
Handling / �+ GENERAL CONSTRUCTION SEDUEMe FOR SUALL
7. Temporary Seeding 7 `-� - 4 �-'Y�l - RESIDENTIAL LOT EROSION AND SEDMHWtCONTROL
Recommendations _ - 1. Prior tothestartotcanstrumm.mntaCtheE.nsrn carnrdUNisontosdvale
8. Permanent Seeding 6 - anon-silew � �l econsnnerrfgwoV*Erosc�ndntgoczar.
2, Install construction entrancevs!
eo - 3� Install che[k damp andlOf IY9510ft�rraal 1lldnloefC rt ral5tle dpaR,•alas rr�
Recommendations _ _ _ a. Install yard inlet prpq'Cpm any pertm lr�lrt�s,sd'eraP_9tMe lame6 elG)
9. Construction Entrance/Exit 9 _ -�- -y �k" j"V" °itl1 F°""'iy—loe"'h Wtea"ul. _-1 '1°'""fs a"
_ _ suggested that each➢ulltleflwmer Instal Ra owrr$te++ce afang 4,e ahBIM aXCd
10 Inlet Protection 10 boundary d silt h+flCa is not recurred akag file Mar W 7C Cr aneID the d[aa,aye
11.Rolled Erosion Control Products i1 ar°n=.Meouiae"rnmtprw�am�.e"W"'=ss the�v;>,pn
envanoe Ensure inlHs downgrade of dia0a4wrra'sare:acmSatl hom$Aon.
{RECP) 5. Prpaeed w$n lnOiVK plot conntr CtCn
12 s. Md�nlaln erosion asd xarrtaltaada xnen�a+rry...+savaarfr-
12.Silt Fence a=td ro9 ththetNPDES WWI otarryala�SWWgn
13-Silt Fence Outlet 137 acCofdggaCe mteSamP pombefor"ede Iasons�esTar_erIX
14 tlisturbiny aGtmt�es are respaltsllse for pnllld ma's•a ensure the approved
14.Silt SockMattle For Check Dams PROJECT NAME: a owr and sedrmenlahcn ant -Isn sE-1111V rca Au a csAn a nGV
15.Silt SockMlattle For Perimeter and 15 mea5creg s�ali�e n a 24-a ur pery naaaer�kWOo'*llfit Old 0-� as
1 0 mp,es or Ill[+f@ Irt a 24-hour pernd-Ttle 9�aGba^'ea`R as�'I as
PROJECT NUMBER: instructions fa-the sett-_pectlon pi'oytarrt age be band at der rtego iNcGol
Inlet Protection m g. Reove any temporary dnvewsy pipeand Illbw i corrm cOo mUa0C9
DATE OF APPROVAL. immedialely pnor to-nu—NV pelfnalwtt*001,e11y
9 Once crosVu&w S c000ele and sY codas we aabfted.rerno,+!any neOm.lny
erasion or sed imentahon awns and s bIllaO wrl areas drshnbed by their renw+ai.
NOTE-FOR ANY PERFORMANCE RESERVATIONS REGARDING THE SEDIMENT CONTROL PLAN(PERFORMANCE a0.Once Me last approved lot is c+ompiala,nobly dw Erosion Co"�Drnwn for
EASED)D)OROR CRITICAL AREAS.A FIELD REVISION OR A CUSTOM PLAN MAY BE REQUIRED a dose-oul Inspecbm_
STANDARD SEDIMENT&EROSION CONTROL PLAN
wr..

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