Floodplain Development Permit Application (Non-Structure)
Applicant Name
*
First Name
Last Name
Applicant Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Applicant Email
*
example@example.com
Location of proposed Development/Project (legal description):
*
Brief Description of proposed Development/Project
*
Contractor
*
Contractor Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Contractor Email
*
example@example.com
Contractor Address
Estimated Cost of Project
*
FLOODPLAIN DETERMINATION
Complete the appropriate information
Project is located
*
100-Year Floodplain (Flood Fringe)
Regulatory Floodway
Other
Map Information
FIRM Date:
*
FIRM Zone
*
BFE at Development/Project Site
*
Development will be elevated to:
*
DEVELOPMENT ACTIVITIES (check all that apply and explain the activity)
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Fill placement (fill brought in from outside the floodplain)
Excavation (where subgrade fill is removed from the floodplain)
Landscaping (cut and fill, fill borrow and placement)
Construction or maintenance of a dike/levee/floodwall
Removal of fill, embankment, or dikes
Watercourse alterations (river, stream, lake - channel modifications, rip-rap)
Road, street or bridge construction (new, repair or replacement, realignment)
Drainage improvements (including culvert work)
Mining (removal of gravel, rock, fill or other natural materials)
Installation of utilities (water, sewer, pipeline, gas, electric, communications)
Well drilling (water, oil, natural gas etc.)
Subdivision (new or expansion)
Other
Describe any of the checked development activities above:
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OTHER NOTIFICATION OR PERMITS NECESSARY:
U.S. Army Corps of Engineers
ND Sate Water Commission
ADDITIONAL INFORMATION REQUIRED (attach additional information):-Comments or further explanation of work-Copies of project description, plans, blueprints, etc.-Wetlands - will the activity impact identified wetlands? -Will the development aggravate flooding elsewhere?
*
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ELEVATION INFORMATION: Attach information about the completed project elevations(s) with registered professional engineer or registered land surveyor certifications if part of the project:
*
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Signature
*
Date
*
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Month
-
Day
Year
Date
For Office Use Only:
DO NOT FILL
ACTION/APPROVAL: The proposed development is in conformance with applicable community floodplain standards subject to the following conditions with this approval. PERMIT APPLICATION IS APPROVED
Floodplain Administrator Name
Signature (Floodplain Administrator)
Date
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Month
-
Day
Year
Date
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