Geauga Soil and Water Conservation District

Application for Review and Approval of a Water Management and Sediment Control (WMSC) Plan (RESIDENTIAL ONLY)

All information, as applicable, must be provided on this form. The review fee shall be submitted with this application and associated plans. Plans will not be reviewed until the fee has been paid and application and plan submitted.

OWNER INFORMATION

Owner Name *

Owner Mailing Address *

City *

State *

Zip Code *

Owner Phone Number (Cell/Home) *

Owner Cell Number (if home number was previously provided)

Owner Email Address *

SITE INFORMATION

Project Type *

Site/Project Address *

Site/Project Parcel # *

Township/City/Village project located within *

Watershed project is within *

Total property acreage *

Total Approximate Project Disturbed Acreage (show to the nearest tenth of an acre -- #.#)
(This MUST include ALL grading, excavation AND the septic area if installing a septic.
This is NOT only the square footage of your buildings.)
FEES WILL BE DETERMINED BASED ON THE TOTAL ACREAGE -- AND MUST INCLUDE ALL DISTURBED GROUND. *

CONTRACTOR/HOMEBUILDER INFORMATION

Is the owner the Contractor/Builder? *

Yes

No

Contractor/Homebuilder Name *

Contact Person Name *

Contractor/Builder Mailing Address *

City *

State *

Zip Code *

Contractor/Builder Phone Number *

Contractor/Builder Cell Phone Number

Contractor/Builder Email Address *

Other Email Address

Total Acreage Disturbed (< 1 acre) $80 Permit Fee

Total Acreage Disturbed (1 - 2 acres) $100 Permit Fee

Total Acreage Disturbed (over 2 acres) $250 Permit Fee

Land Clearing ONLY for an impending residential build ($60) Fee

Proposed (approximate) construction start date * +

Proposed (approximate) construction end date * +

CERTIFICATION *

By checking this box and providing your name and signing below, I certify under penalty of law that this document and all attachments were prepared under my direction or supervision and are to the best of my knowledge and belief, true, accurate and complete. I authorize the Geauga Soil and Water Conservation District (SWCD) agents to enter this property for the purposes of plan review, site inspection or compliance with the Water Management and Sediment Control Regulations for the duration of the project until the Geauga SWCD can close the project and all bare soil is stabilized with vegetation.

Please Sign *

clear

Type Name Signed above *

Affiliation *

Email Address to send Receipt and Confirmation *

Please upload your site plan below. If unable to upload using link below you may email to geaugaswcd@geauga.oh.gov after completing this form to submit your payment and application.

Upload applicable documents for review (example: site plan and details)
(Multiple documents can be uploaded at one time. All files combined must be less than 10MB)