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NCC241700_ESC Approval Submitted_20240607
4,03.04 FPS`' (1 Bryce A.Stuart Municipal Building hQ ¢ Suite 328 Single-Family Dwelling tt:sre,;. ,„ 100 E.First Street IN$PEC ORS City of Winston-Salem Winston-Salem,NC 27101 DIVISION Excellence throughsemi" Erosion Control Permit Application Field P.O. Box2511 Operations Winston-Salem, NC 27102-2511 Please use this form when the Developer and Builder are not the same Phone:311 or(336)747-7453 financially responsible party/person and will be less than one (1) acre of Fax:(336)727-2792 land disturbance on any one (1) lot. Lot(s)to be Developed Information Site Address: (L( - `hl , 7 R, �/ Subdivision Name: / �1..L L�t , ScL Anticipated Dates of Construction Activity: Start: S~- d 4 Completion: - 2- _ z.s ***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 Party/Person Name: rA Y\ t-1--L. (7.4zv s- H 1 Address: / 2 kf 4 1. / City/State/Zip: J) - 5 4 ' - `7 J 0 Office Phone: Mobile Phone: "3 _44 2--ti y 6 2 Email Address: 114 n ri, 7z-,2,' & /14 ,'/. My signature hereto signifies I am the owner/financially responsible party for job site compliance with the Erosion Control Ordinance as outlined in Chapter,Section 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 attached sketch plan must be properly installed and maintained to retain soil within the constructed lot. I understand that if 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. I�,,�/i/^ � _,/ �� � JEANETTE WEAVIL �' z" T/ Notary Public Print Name of Financially Responsible Person Forsyth Co.,North Caro' a , My Commission Expires Fob.110,'Mine of Financially Responsib er on Stt N(' County of: TO BE COMPLETED BY CITY STAFF ONLY: The foregoing instrumen was acknowledged b ore a lit) day of t Date of Application Submittal: Permit Number: blame Here, Notary Public / My Commission Expires Ali ( 9-7). , 1 ,.... r- <1c. m 72 1 1- a o m m m u r , r c 3 -.J +, m m ` m a m r r z m 0 73 3 O n z o z m 0 m 3 A m D O x O -4 0 v m ro o -1 Si� m D r m0 m 0 �— m v 0 D. m z 0m A A Z m 7' m 9'- D N n a D o m "'An n 0 r .1 .i r +4 wI m 4 40 2 m ^7 m v n c^Di m 03 D co m n .— - _ O m Q -n 0 0 D X W z x "`� m -1?-' D m m 1 r N X z in 0 j o m r z O m 1 i i I o m 2 m a 02,, "0 Q o z A x o • 7 com o m 0 m o . m D @ Q p m 0 0 to c°' • � � b 0 m to pj s= z -1 • 7 0 2 K j RI rmn v rav . . . 1 I N I "Cs 0_ • o CD Q N •O • m 31d@ ' Q tO 0 a s a, CO C v o 0) 0 �= coa, o 0 o,> x- LO ra ° .) ° N OV a, 0 ---7 N W as 2 c i U Q , O 'C L a _ _ W cam, a3 w a JC? me a,y as- � (� �o Nco w L w (0c `o c -i m 'a La = cc000a3c� m E,_ 1- m vQNv o 0 3Q fit- o � o ° mm ° w rn-° NcEmZc to_co 9 ,,°, [0 N N o O C9 N (nuO o .0 c m"'c" U�. o - N °_' c ° m v,m m a 2 N "a ° - - - -0 i-to _'- U ,o W i ca" v= ,,9 ] p L U 17 p 0 m m w-o.� 3 10 Z :� U > D y ° co o 0 o Far O p 4 O I J o 0 w_, v-0 -._ rn m p - v o o t m o vmi a,o °, m m a a' o W o ryca73 a L 3s �, � o © ��ww aoozio°c ° ° moo a v L� O c c, v o }, m e s, U tv yy" 0m mocuQro 0) m c amp,-ua � ww =oc ,c-va, w ° mm om my °x a� Zcan famo all o w0x c o 0 3us0w ___ (� V3 6 ° « w o• a) c0OOtnoa'13 cv `63 � >.w 0 Q Qva a, �, Naifl6� a, o•m [] 0 Q so-ao,t.- E0 30 g „-° oj (0N S, N to"O L - -0 N m 0 . ,_ 2 L11 v.c i v•" u, Z, o -o °' a, _ N +s-• Q sr, o N!- w .� >44 co 4 O,Q O t a) Ill A O tt. ,..t- N to W n o `° - -9 a, N w ? 3 C m U o ° Z . 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C m is o o, m chi c a m N c L o m m Y m Q. m"a o CJ _ t-- 4-a,4� o oFZOtLQ4z IL-ct a`. v.-� o w o > ®a-ti 030-- ^ m c ID E E o w o 0 0 [C._q a,0 m - ni ri r N V u, co t� 07 6 Q cl ••--- N of vi 6 n� co c3i O I„'" A i . ,.. � y w Q :. 0 4 0 Z 4 0 0 Pam, O W --•9 4w'0 Et 7)/ 4re Z CO `W c r V ', O m MI ce "•c fY4 _- 0 ag 0z W <Z 4 �= z� CO (n Q !17 O:1 H w w 0o a Q w z 1 ►- s a a p cc Q0 Cl) z 1-- --I a cc LL ( .- N c., V , to I"- O N m r e- 0 v�Q sil CC Q r U Z303 w 0in u o Q wz UQ Z CO o o `� ` E->, CC al © W v O N 43 a. L '0 O04 +' > 0 © d w O F"' � a J - 0 O 0) 0) C C i i 4❑ Z `� ~ c6 L a u�i zs 'a i4 II- z W 0 4 o o p c CO t7 as a) CDU cis 0 0 Q S Fa- 1- � F�UF�'R4' ZZ2F CCD VL' a.., USce co65u) (A C - . r- fV CO y Lf) CoN- cp CS) O r N Ch `i Ln 0 e c- t- t- r CM I 5/16/24,6:48 AM Gmail-Review Completed-9149 Top Ridge Ct.-Lissara-SFD Construction Gmaii Matt Menzi<mnmenzi@gmail.com> Review Completed -9149 Top Ridge Ct. - Lissara -SFD Construction 1 message City of Winston-Salem<noreply@geocivix.com> Thu,May 9,2024 at 9:26 AM Reply-To:matthewo@cityofws.org To:mnmenzi@gmail.com Winston-Salem Application Type:04.02)Grading/Erosion Control Permit Workflow:04.02)Grading&Erosion Control Project:9149 Top Ridge Ct.-Lissara-SFD Construction A/P#:EN2400120 Acreage to be Disturbed:0.20 https://wi nston-Salem.geocivix.com/secure/project/?prof ectid=1331558 Hello Homes by Matt Menzi,Inc., Thank you for submitting your project to City of Winston-Salem.Review of the Erosion Control Plan for this project has been completed.The design is adequate to meet the ordinance standards and the plan has been approved. Be aware that this plan shall expire three(3)years following the date of approval,if no land disturbing activity has been undertaken,as is required by Title 15A NCAC 4B.0129. Also,acceptance and approval of this plan is conditioned upon compliance with Federal and State water quality laws,regulations,and rules. If you have not already done so,please provide an original signed and notarized Financial Responsibility/Ownership(FRO)form as applicable.This document is required prior to the issuance of the Grading/Erosion Control Permit.If this has already been provided,then please disregard this statement. Reminder that a completed FRO form is not required in the instance where a project qualifies to use the HB 489 Sketch Erosion Control Plan document. If this project will disturb more than 1 acre or is part of a larger common plan of development,the Grading/Erosion Control Permit cannot be issued until documentation is provided that coverage under the NCGO1 Construction Stormwater Permit(NPDES)has been obtained. Please obtain coverage under the permit at the following website(https://edocs.deq.nc.gov/Forms/NCG01-N0I). Once coverage is obtained,please upload a copy of the Certificate of Coverage(COC)to the project documents in the electronic plan review system. The Grading/Erosion Control Permit will not be issued until proof of coverage under NCGO1 is provided. Please direct questions about the eNOl form to NCDEQ- DEMLR Stormwater Program staff in the Raleigh central office. If the owner/operator of this project changes in the future,the new responsible party must obtain a new COC. ***This approval email serves as the"Approval Letter"that must be uploaded when filing the e-NOI application to obtain the NCG01 Certificate of Coverage.*** As outlined in the Unified Development Ordinances(UDO)of Winston-Salem/Forsyth County,Village of Clemmons,Town of Lewisville,and Town of Walkertown,Erosion Control Division staff may periodically inspect sites of land disturbing activity to determine compliance with the Erosion Control ordinances and the approved Erosion Control Plan. No person shall willfully resist,delay,or obstruct an authorized representative,employee,or agent of the Erosion Control Division while that person is inspecting or attempting to inspect a land disturbing activity under the ordinance. Should you have any questions as you move forward please contact Kent Wall at 336-462-7481 or ken w cityofws.org. Winston-Salem North Carolina and Forsyth County City Link 311 311 or(336)727-8000 citylink@cityofws.org 100 E.First Street Winston-Salem,NC 27101 City Directory https://mail.google.com/mail/u/0/?ik=7473e4e2ce&view=pt&search=all&permthid=thread-f:1798581725395515012%7Cmsg-f:1798581725395515012... 1/1