SUSPENDED FORM

Other permits: An Aquatic Resource Alteration Permit (ARAP) may be required. If your work will disturb or cause alterations of a stream or wetland, you must obtain an appropriate ARAP before you will receive a City of Portland Land Disturbance Permit. If you have a question about the ARAP program or permits, contact your local Tennessee Department or Environment and Conservation Environmental Assistance Center.If you are disturbing one (1) acre or more you will need a State of Tennessee issued Construction General Permit along with the following documents, prior to obtaining a City of Portland Land Disturbance Permit.

Storm Water Pollution Prevention Plan (SWPPP):

Yes No N/A

Notice of Intent (NOI):

Yes No N/A

TDEC Notice of Coverage (NOC):

Yes No N/A

Erosion Prevention & Sediment Control Plan:

Yes No N/A

Long Term Maintenance Plan:

Yes No N/A

Maintenance Agreement Recorded on Property Deed:

Yes No N/A

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Land Disturbance Permit Guide

Grading work must commence within 60 days of issuance or grading permit will be void.
The permit is valid for one (1) year from date of issue ---- after that date, you must contact this office for renewal.
Where applicable, work shall also conform to the requirement as for construction done near or in a stream potentially affected by the project set forth in the Aquatic Resource Alteration Permit (ARAP) as issued by the Natural Resource Section of the Tennessee Department of Environment and Conservation and the Department of Army permit issued by the Corp of Engineers or work in or near delineated wetlands. No work shall commence within a TVA easement until TVA has granted permission and written verification is provided to the City of Portland. The contractor and/or developer shall be responsible for obtaining all permits required by agencies and/or governmental entries having jurisdiction.
Erosion control devices, as shown on the approved Erosion Prevention & Sediment Control Plan (enclose plan with this Land Disturbance Permit) shall be in place prior to any grading, clearing and/or any other construction activity. These devices shall be maintained throughout the construction period; generally considered to be through the completion of restoration. A copy of your EP&SC plan along with an inspection checklist and Storm water Permit must be at the project site at all times. The inspection checklist shall have a record of dates EP&SC devices are inspected and any correction action taken or major observations.
All EP&SC devices are to remain in place until the site has been stabilized and a good stand of grass has been established.
Erosion prevention and sediment controls must be inspected at least twice every calendar week and at least 72 hours apart. Inspections are to be documented and kept with the SWPPP.
The project is subject to inspection by the City of Portland at any time and items found deficient shall he immediately corrected. The City may stop construction on properties, or administer other enforcement actions as defined by Portland's Storm water Management Ordinance including Civil Penalties of $50 to $5,000 per day, per violation.

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The following erosion prevention and sediment control BMPs will be preformed until Bond is released: PLEASE READ AND SELECT EACH REQUIREMENT BELOW.

Vegetative buffers or other protection must be provided along streams, rivers, and ponds to avoid erosion of banks.

Stabilization measures must be performed within seven (7) days in portions of the site where construction activities have temporarily or permanently ceased, and within fifteen (15) days after final grading.

All trees designated to remain, must be protected. Heavy equipment should not be operated or stored, nor materials handled or stored, within the dripline of trees.

Sediment must be removed from sediment barriers, ponds and other sediment controls when design capacity has been reduced by 33%.

Sediment that has escaped the construction site and has collected in the street or drainage structures must immediately be removed.

Building and waste materials, and non-storm water discharges, such as concrete, paint wash water, or machinery leakage or spillage must be managed to prevent them from entering the Stormwater system, ground water or nearby water body.

BMPs must be inspected by a qualified person who has taken an approved erosion and sedimentation course.

Issuance of this Land Disturbance Permit does not exempt you from complying with any provision of the City of Portland's Stormwater Management Ordinance that applies).

I certify, under penalty of law, that I have reviewed this document and understand the erosion prevention and sediment control requirements are here in. I agree to implement and follow the provisions of the Land Disturbance Permit for the construction site. I understand that these requirements will be inspected and enforced by the City of Portland and failure to comply my result in the issuance of a "stop work order" and/or other penalties until compliance is accomplished. The undersigned will be responsible for complying with this permit and any provision of the Portland Stormwater Management Ordinance that applies.

Name:

Date:

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Property Owner Name:

Mailing Address:

Property Owner Phone #:

Email Address:

Project Name:

Contractor Name:

Contractor Phone #:

Subdivision/Section:

Lot #:

Map #:

Parcel #:

TDEC Permit #:

required if equal to 1 or more acres are disturbed.

Erosion Control Installer:

Starting Date:

Completion Date:

Land Area Disturbed:

Street Address:

Construction Address: DO Not include City, State, or Zipcode. Example: 100 South Russell Street is all that is needed.

Additional Comments: