Instruction for Completing the Individual Lot Notice of Intent (NOI) Form
Preface
These instructions explain
how to fill out the Individual Lot Notice of Intent (NOI) form.
Erosion and sediment
control during construction activity is important. Implementing Best
Management Practices (BMPs) can save time, money and worry, and protect
natural resources. Additionally, practicing erosion prevention instead of
erosion repair may help avoid problems such as negative publicity or private
party lawsuits, fines and stop work orders.
Who Must
File and Individual Lot Notice of Intent (NOI) Form
You must file for an
Individual Lot Notice of Intent (NOI) if your construction activity is
located within a platted named subdivision and the construction includes a
residential building or an accessory building over 576 square feet in size.
So what
is expected of me as a builder or lot owner?
Persons signing this form
should be familiar with erosion and sediment control requirements applicable
for Washington County. Local erosion and sediment control requirements can
be found on the Washington County Planning Department website
www.washcoplanning.org or in the Douglas Co./Washington Co. Stormwater
Management Policies. The completed form also serves as transfer of
responsibility from the prior owner of the property (developer) to the new
owner of the parcel. All responsibility regarding installation and
maintenance of sediment control measures is solely the responsibility of the
new owner.
Where to
file an Individual Lot NOI Form & Fee
Individual Lot NOIs must
be filed at the Washington County Planning Department (located at 1555
Colfax Street, Blair, NE 68808) when applying for a building permit. The
estimated fee for the Individual Lot NOI is $800.00 as per Washington County
Resolution #2008-25. The applicant shall pay this fee at the time of
application.
Completing the Form
The staff at the County
Planning Department will assist you in completing the NOI. It is your
responsibility to select one of three possible site plans or create a site
specific plan with sediment controls.
Section I
– Applicant Information/Mailing Address
Give the legal name of the
person, firm, public organization, or any other entity that is performing
the construction of the site. The responsible party is the legal entity
that controls the site rather than the job site supervisor. Give the name
and phone number of the contact person who is responsible for addressing
these requirements. Enter the complete address and telephone number of the
applicant. Correspondence will be mailed to this address.
Section
II – Site Location Information
Enter the official or
legal name of the subdivision including lot and block numbers, and the
complete address including city, state and zip code.
Section
III – Construction Activity Information
Enter the project start
date, estimated completion date, and the disturbed acreage for the lot.
Section
IV – Certification
By signing the form the
owner indicates that they are solely responsible for the requirements for
erosion and sediment control for the lot and will comply with the terms and
conditions stated on the form and with Resolution #2008-25.
Office Use Only
|
Construction Stormwater Permit # |
|
|
Received By |
|
|
|
| |
|
|
Individual
Lot Notice of Intent (NOI)
For
Construction Activity that is in a Platted Named Subdivision per Resolution
2008-25
|
Submission of this form
supercedes any prior Notice of Intent (NOI) and Stormwater Pollution
Prevention Plan (SWPPP) for the lot indicated in the application and
fulfills the notification and discharge authorization procedures for
individual lots, as required by Washington County Resolution #
2008-25.The applicant assumes sole responsibility for the building
phase of development for this lot.
|
|
I. Applicant Information |
|
Name of Applicant: |
|
Legal Interest in the
Land: |
|
|
Company Name: |
|
|
24-hour Contact Person: |
|
Phone: |
|
|
Mailing Address: |
|
|
City: |
|
State: |
|
Zip Code: |
|
|
Lot Owner (if different from Applicant) |
|
Name: |
|
Phone: |
|
|
Mailing Address: |
|
|
City: |
|
State: |
|
Zip Code: |
|
|
|
|
II. Legal Description |
|
Name of Subdivision: |
|
Lot No. : |
|
Block No.: |
|
|
Construction Site
Address: |
|
|
City: |
|
State: |
|
Zip Code: |
|
|
|
|
III. Construction Activity Information |
|
|
Estimated Start Date |
|
Estimated Completion Date |
|
Estimates Disturbed Acreage |
|
|
|
|
|
|
|
|
|
|
|
|
IV. Certification
I certify under penalty
of law, that I am familiar with and agree to comply with the terms
and conditions provided in this Notice of Intent (NOI) and
Stormwater Pollution Prevention Plan (SWPPP) and that I am solely
responsible for the individual lot covered by this NOI and SWPPP. I
understand that both Washington County and their hired Nebraska
Licensed Professional Engineering Firm are authorized to inspect the
site at reasonable times pursuant to Washington County Resolution
No. 2008-25 |
|
Signature: |
|
Date: |
|
|
|
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Individual
Lot SWPPP (Stormwater Pollution Prevention Plan)
For Construction Activity
that is in a Platted Named Subdivision per Resolution 2008-25
Initial
on each line to indicate that you have read and understand the following:
1.
I have used: ___ Site Plan A ___
Site Plan B ___
Site Plan C ___
My Own Site Plan (select one),
annotated as needed.
2.
All BMPs will be constructed, installed and maintained according to the
minimum standards and specifications set forth in either Douglas
Co/Washington Co. Stormwater Management Policies, the NPDES General Permit,
or otherwise approved by the Washington County Planning Department and will
be in place and in working order prior to any construction activity.
3.
BMPs will be installed, operated and maintained to protect streams, rivers,
ponds, and wetlands from sedimentation and a spill prevention plan will be
followed for any spills or illicit discharges that may leave the site.
4.
Proposed BMPs are shown on the attached Site Plan. The construction details
application schedule, procedures, operations, and maintenance of the
proposed BMPs are in conformance with Douglas Co./Washington Co. Stormwater
Management Policies and current standards.
5.
If applicable, any features of the site that are vulnerable to erosion, as
well as BMPs implemented for these features are shown on the attached Site
Plan.
6.
All BMPs will be inspected as per Resolution 2008-25 and by County Planning
staff
7.
Sediment deposited into or upon any street, alley, sidewalk, public way,
storm drainage system, or public ground will be removed within a reasonable
period of time. A contingency plan will be implemented for unforeseen
erosion or sediment problems, including emergency situations caused by
storms.
8.
Following any construction activity, final or temporary stabilization shall
be completed as soon as practicable, but in no case more than fourteen days,
to the surface of all perimeter controls, topsoil stockpiles, and any other
disturbed or graded areas on the project site which are not being used for
materials storage, or which actual construction activity is not being
performed.
9.
Either the lot will be stabilized by the builder at the end of construction,
or the homeowner will be informed of the need for final stabilization.
|
Site Plan for Individual Lots
Type C
Not to Scale
|
|
Reduce sediment leaving
your construction site by implementing Best Management Practices (BMPs)
such as: |
 |
|
1. Limit mud track-out
onto private or public streets by parking on paved streets or driveways
whenever possible. If necessary, utilize a temporary gravel drive. |
|
2. Clean up any mud that
has been tracked off the construction site in a thorough and timely
manner. |
|
3. Implement sediment
controls along the lower sides of the property to protect adjacent
waterways, storm drains or neighboring property from sedimentation. |
|
4. Keep a clean site.
Dispose of construction waste materials and debris in a dumpster or
containment device. |
|
5. Have your portable
toilet staked and anchored away from any storm drain inlets. |
|
6. Inspect your site
weekly and after rain events to find any potential problems and keep
your Best Management Practices repaired and in good working order. |
|
Contact the Washington
County Planning Department for more information on Best Management
Practices for erosion & sediment control. |
|
|
|
|
|
|
|
|
|
DATE PREPARED: |
|
|
|
|
NAME OF PREPARED: |
|
|
DISCLAIMER: |
Washington County incurs no
liability for the use or misuse of this site plan. |
