Soil Erosion & Sedimentation Control Waiver Form
Minor residential projects that expose less than 225 square feet of soil and are not within
an “Environmentally Sensitive Area”, as noted in the criteria below, may be eligible for a
soil erosion and sedimentation control waiver.
Please provide the following information if requesting a waiver.
Name: _____________________________________Phone:______________________
Address: _______________________________________________________________
Description of Proposed Project: _____________________________________________
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Residential: ___________
Commercial: ___________
Total Soil Disturbance: ____________Sq. Ft.
Agriculture: ___________
Date: _______________________
Signature: ___________________________
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Environmentally Sensitive Area Criteria:
The Following Information to be filled out by Erosion Control Officer:
1.) Distance to Lake, Stream or Wetland: 100 ft. or less _____ Greater than 100 ft._____
2.) Planned grade of finished driveway: 10% or greater _____ Less than 10% _____
3.) Potential for Flooding: Yes ______ No ______
4.) Soil Type: Sand ______ Silt ______ Clay _______ Organic______
5.) Other identified sites: High Risk Erosion Area ______ Critical Dune ______
Other Area: (Explanation) ___________________________________________________
Waiver Approved: ___________
Waiver Denied: ___________
Signed: ________________________
Soil Erosion Control Officer
Date: ________________