HomeMy Public PortalAboutConstruction Site Erosion and Sediment Control COSESCO Permit FormCity of Riverdale, Iowa 110 Manor Drive, Riverdale, Iowa 52722 • (563) 355-2511 • www.riverdaleia.org
CITY OF RIVERDALE, IOWA
CONSTRUCTION SITE EROSION AND SEDIMENT CONTROL (COSESCO)
RESIDENTIAL APPLICATION
PROJECT INFORMATION
Project Address
Subdivision
Lot # Area of Disturbance: ☐Under 1 acre ☐Over 1 acre
Will geothermal wells be drilled on this site? ☐Yes ☐No
Description of Work
Estimated Start Date
Estimated Completion Date
OWNER INFORMATION
Name
Mailing Address
Phone
BUILDER INFORMATION
Name
Mailing Address
Phone
Email
TERMS
1. COSESCO permits are valid for one (1) year from the date of issue. If final stabilization is not achieved as
defined by the Iowa Department of Natural Resources (IDNR) in their General Permit #2, the permit must be
renewed. Operating without a valid permit is a violation and will result in a stop work order and associated
penalties.
2. This permit must be approved prior to any land disturbing activity.
3. The controls indicated on the Storm Water Pollution Prevent Plan (SWPPP) must be in-place, maintained,
and any changes recorded.
4. The applicant assumes all responsibility for the SWPPP and amendments and will certify the SWPPP
complies with all requirements of the COSESCO ordinance any state and/or federal requirements.
5. The applicant agrees to pay all fees associated with this permit.
City of Riverdale, Iowa 110 Manor Drive, Riverdale, Iowa 52722 • (563) 355-2511 • www.riverdaleia.org
6. By signing this document, the applicant certifies that all information submitted above is correct and the
applicant agrees to the terms.
APPLICANT CHECKLIST
Have you attached a copy of the approved erosion control plan/SWPPP, and have signed
the certification statement in it? ☐Yes ☐No
Have you attached a detailed site plan including flow lines, track pad, sediment barriers,
and protection of any intakes or basins?☐Yes ☐No
Have you reviewed and will you comply with all requirements of the General Permit #2
from the IDNR? ☐Yes ☐No
Have you read and understood the terms listed above? ☐Yes ☐No
Have you attached the $75 application fee? ☐Yes ☐No
APPLICANT SIGNATURE
Signature Date:
Submit this form and attachments to:
Operations Manager, Public Works Department
City of Riverdale, Iowa
110 Manor Drive, Riverdale, IA 52722
operations@riverdaleia.org
(563) 949-0464
FOR OFFICE USE ONLY
Before a COSESCO permit can be issued, the following must be submitted by the applicant and approved by
the City of Riverdale, Iowa:
☐Erosion Control Plan/SWPPP.
☐Detailed site plan including flow lines, track pad, sediment barriers, and protection of any intakes or
basins.
☐Completed application form.
☐$75 fee.
Inspection Dates:
Inspected By:
Deficiencies Noted:
Permit Issued: ☐Yes ☐ No Permit Number:
PERIMETER SEDIMENT BARRIER
LOT BOUNDARY
BACK OF CURB
CENTERLINE ROAD
GRAVEL ACCESS PAD
PROPOSED HOUSE
RESIDENTIAL LOT TYPICAL STORM WATER POLLUTION PREVENTION PLAN
SCALE: NONE
NOTE:
PLACEMENT OF PERIMETER
SEDIMENT BARRIER SHALL NOT
IMPEDE THE COURSE OF ANY
DRAINAGE DITCH OR FLOW TO A
NEARBY INTAKE.
TYPICAL PROPERTY LINE
ROADWAY
LOT NUMBER: ___________
THE INSTALLATION OF SEDIMENT FENCE
BEYOND THIS POINT IS NOT REQUIRED UNLESS LOT
IS ADJACENT TO A PERMANENT DETENTION BASIN.
ALL REAR YARD DRAINAGE INLETS SHALL BE PROTECTED
FROM SEDIMENT FLOWING INTO THE INLET.
PL
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WOODS ESTATES LOT DEVELOPMENT
CITY OF RIVERDALE
SCOTT COUNTY, IOWA
RESIDENTIAL LOT SWPPP
PROJECT NO.
10876065
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GENERAL SWPPP NOTES:
1.EACH HOME BUILDER WILL BE RESPONSIBLE FOR FURNISHING / INSTALLING A CONCRETE WASHOUT
FOR THEIR USE.
2.NO EQUIPMENT IS TO BE WASHED ON LOT.
3.NO EXISTING TREES MAY BE REMOVED BY THE HOME BUILDER. ONLY THE DEVELOPER IS
AUTHORIZED TO REMOVE TREES.
4.PRIOR TO PLACING TOPSOIL, THE ENTIRE LOT SHALL BE GRADED AND THEN DISKED TO LOOSEN THE
SURFACE SOIL.
5.THE HOME BUILDER MAY NOT REMOVE ANY TOPSOIL FROM THE SITE.
6.ALL WASTE MATERIALS ARE TO BE REMOVED FROM THE PROJECT SITE. NO BURNING OR BURYING
OF WASTE MATERIALS IS ALLOWED.
7.PRIOR TO RECEIVING THE AUTHORIZATION FROM THE CITY OF RIVERDALE TO PROCEED, EVERY
HOME BUILDER SHALL SIGN A COPY OF THIS RESIDENTIAL SWPPP INDICATING THEY HAVE READ IT,
UNDERSTOOD IT, AND WILL COMPLY WITH IT. ONE SIGNED COPY SHALL BE SUBMITTED TO THE CITY
AND ONE SIGNED COPY SHALL RETURN TO THE DEVELOPER.
8.WHEN THE HOUSE CONSTRUCTION IS COMPLETE AND TURF IS ESTABLISHED, THE HOME BUILDER
WILL CONTACT THE CITY FOR FINAL ACCEPTANCE. UPON RECEIVING AN ALL CLEAR, THE HOME
BUILDER IS NO LONGER RESPONSIBLE FOR THE RESIDENTIAL LOT SWPPP.
9.AT THE END OF EACH WORKING DAY, THE HOME BUILDER SHALL REMOVE ANY EARTH OR
MATERIALS TRACKED ONTO THE STREET.
DATES INSPECTED: 1.___________ 2.___________ 3.___________ 4.___________ 5.___________
INSPECTED BY: 1.___________ 2.___________ 3.___________ 4.___________ 5.___________
DEFICIENCIES NOTED:
1.
2.
3.
4.
5.
DATE DEFICIENCIES
ARE EXPECTED TO
BE CORRECTED BY: 1.___________ 2.___________ 3.___________ 4.___________ 5.___________
I HAVE REVIEWED THIS LOT SWPPP ASSOCIATED WITH LOT # ___________ OF THE WOODS ESTATES
DEVELOPMENT. I UNDERSTAND ITS CONTENTS AND INTEND TO COMPLY WITH THERE REQUIREMENTS.
__________________________________________________DATE:____________________
AUTHORIZED AGENT FOR HOME BUILDER