INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM

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TOWN OF HOLLY SPRINGS ENGINEERING DEPARTMENT PO Box 8 Holly Springs, NC 27540 (919) 557-3938 FAX (919) 552-9881 The following items must be submitted with the complete, signed and notarized Application for Timbering Plan Approval and Timbering Permit/: Environmental Review Fee & Fee Calculation Sheet Five (5) FULL sets of folded 24 x 36 Timbering Plan including calculations and other supporting documents. Engineering calculations, reports, etc. Environmental Assessments required (e.g. DWQ Documentation) 8 ½ x 11 copies of USGS and Wake County Soil Survey stream information for the project location. A copy of the forestry management plan prepared or approved by a registered forester. Affidavits provided by the landowner indicating the intent and scope of the timbering activity. All of the above items must be received Monday by 12:00 noon for the application package to be considered complete and review of Construction Drawings and Erosion Control Plan to begin. The review cycle for these plans begins on a Monday and comments will be provided two (2) weeks after the start of the review cycle. The review cycle will begin the Monday following submittal of a complete application package. The review process will be delayed if incomplete or out-of-date forms are used, if the package is not complete, if the form is not signed and notarized, and/or the fees are not paid. Expiration of Timbering Plan Approval Timbering plan approval expires after one (1) year if work has not begun (based on the definition of the start of construction in the Ordinance). Issuance of a Timbering permit does not prevent the plan approval expiring after a year if construction has not begun. INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM Please type or print in ink. Please Do Not Use a Pencil! 1. Project : Give the name and phase of the development, subdivision, shopping center, road, sewer line, etc. for which the plan approval is required. Use the same name used for previous approvals. 2. Description of Timbering Activity. Please provide a brief description of what is being timbered on site? List all the various components of the project. 3. Landowner(s) of Record. Give the requested information for all of the current owners listed on the deeds and/or recorded instruments listed in number 5 below. Give all of the information requested for each owner. 4. Future Landowner(s), If Applicable. If another person(s) or firm(s) will take possession of the property and initiate and conduct the land disturbance, give the requested information for all of the future owner(s) to be listed on the deeds and/or instruments to be recorded. Give all of the information requested for each owner. This does not apply to subdivisions where individual lots may be sold to many different builders or homeowners and it is unrealistic for the person financially responsible to know or involve these owners in

INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM (CONT.) advance. Example: where a tract is under a purchase option, show the current owner as the Landowner and the future Landowner as the developer holding the option and developing the property (applying for subdivision approval, erosion control plan approval, etc.). 5. List Book and Page Where Deed or Instrument Is Filed in Wake County. List the reference for the site as found in the Wake County Register of Deeds Office. If more than one lot, deed, or instrument is involved, list all the appropriate references. 6. Person(s) or Firm(s) Financially Responsible for the Timbering Activity. This will be the owner, developer, the person or firm holding a lease or option on the property. It is the party paying the bills for the development, disturbance, and construction of the property. For the Erosion Control Plan: This is not the building or grading contractor who will be hired to perform the clearing and implement the erosion control plan even though there is a contract agreement stating that the contractor is responsible for implementing the erosion control plan. The contractor is liable to the owner/developer and the owner/developer (i.e. the person financially responsible) is liable to the Town for both the implementation and success of the approved timbering plan. Statements on the timbering plan that the contractor is responsible for tree protection measures does not remove responsibility for compliance with the Ordinance or for enforcement actions from the person(s) or firm(s) financially responsible. 7. Registered Agent, If Any, for the Person Financially Responsible. In accordance with the Sedimentation Pollution Control Act of 1973, a North Carolina agent is required if the applicant is not a resident of North Carolina. This may be an attorney, engineer, etc. acting as an agent for the owner of this site. 8. Plans Prepared By. Provide the name, mailing address, and telephone number of the person or firm that prepared the Timbering Plan. Provide the name of an individual to contact concerning the plans. In the interest of time and effort, engineering department personnel will contact this person about revisions to the proposed timbering plan instead of contacting the owner/developer or contractor. 9. Location Description. Give a brief description, such as street address, road number, road name, etc. In addition, provide: Parcel Identification Number (PIN) What is the PIN assigned to this property? Tax Map, Block, and Lot Number How is the property listed in the Wake County Tax Records? (If you do not know both the PIN and the tax map, block, and lot number, one property identification is sufficient.) 10. Site/Project Information. Size of Tract how many acres are in the whole site being developed (gross acreage of site)? Area Disturbed How much area will be timbered and/or disturbed? Give the area in both acres and square feet (ft 2 ). Watershed Is the project in the Cape Fear River or Neuse River Basin? Temporary stream crossing(s) required How many stream crossings if any will be required, Additional permitting may be required by NC Division of Water Quality prior to issuance of the timbering permit. Riparian Buffers How many linear feet and width of riparian buffers (Town or NC DWQ) are on the tract?

INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM (CONT.) Planning and/or conservation buffers Are there any present on site and brief description of the buffers on site? 11. Timbering Plan Exemption. If you are seeking an exemption from the Town s Timbering Plan Requirements the following must be submitted with this application. A copy of the forestry management plan prepared or approved by a registered forester pursuant to Chapter 89B of the NC General Statutes. Affidavits provided by the landowner indicating the intent and scope of the timbering activity. 12. Approximate Date Tree Harvesting Will Begin. Give the best estimate possible when the actual tree harvesting work will begin. As soon as the plans are approved and a timbering permit is issued (abbreviated ASAP ) is an acceptable answer. 13. Signature and Witness. This application and statement of ownership must be signed under oath by the financially responsible person, if an individual, or by an officer, director, partner, attorney-in-fact, or other person with authority to execute instruments for the financially responsible person if not an individual. This form must be signed in the presence of a Notary Public and signed and sealed by that Notary. FEES An Environmental Plan Review fee must accompany this application in order for the review process to begin. Payment by check is preferred, and checks should be made payable to Town of Holly Springs. Fees are subject to change; if in doubt or you have not submitted a plan recently, contact engineering department personnel to ensure this is the current fee schedule. The following schedule was current with the date of printing shown in the bottom left hand corner on this form. Fees are not refundable, even if the plan is never approved, the approval or permit expires, or the proposed disturbance is never carried out. Round off the fee to the nearest whole dollar. Please refer to the Engineering Department Fee Schedule for current fees. When and Where to Submit the Application At least 30 days before the start of work. GENERAL INFORMATION A complete application package and plans shall be dropped off by 5pm on Monday s to the Administrative Office of the Engineering Department. If the package is received after 5pm on Monday it will fall into the following weeks review schedule. If you have any questions about completing the application, current fees, etc. contact engineering department personnel at the telephone number at the bottom of last page of the instructions.

GENERAL INFORMATION Review and Response to Plan Submittal Action will be taken on the submittal within the 14 working days, in line with the construction drawing review cycle (Monday to Monday). Unless the plan is perfect, expect multiple reviews that will take in excess of 30 days for review. The approval process may take considerably more than 30 days on complex sites or when multiple revisions to the plans are necessary. Review of Timbering Plan The plan will be reviewed and the designer contacted if there are questions or if revisions are needed. A site investigation is normally a part of the review process. The Ordinance gives environmental personnel the authority to enter the site to conduct investigations and to ensure compliance with the approved plan and the Ordinance once work begins. The plan will be approved, approved with conditions of approval, approved with performance reservations or, if it cannot be approved staff will discuss the needed revisions with the designer in an effort to resolve the problems so that it can be approved. If these efforts are unsuccessful, the plan will be disapproved. Disapproval of the plan or conditions applied to the approval can be appealed. Once approved, a Certificate of Plan Approval will be issued and is usually sent to the designer since they often need it to get other approvals. A letter will also be sent to the person(s) or firm(s) financially responsible for the land-disturbing activity explaining expectations, their responsibilities, inspection procedures, enforcement actions, etc. Timbering Plan Approval If timbering is to take place prior to the issuance of a grading permit a separate timbering plan application must be filled out and submitted with the 5 copies of the timbering plan Exemptions An exemption from the Timbering Plan requirement may be obtained if the forestry activity is conducted pursuant to a forestry management plan or approved by a registered forester pursuant to Chapter 89B of the NC General Statutes. A copy of the forestry management plan prepared or approved by a registered forester shall be submitted to the Town prior to or at the time of initiation of timber harvesting for the site. The landowner shall be required to provide affidavits indicating the intent and scope of the timbering activity. The Town shall review all of the information provided by the landowner in the review process stated above. Upon completion of the review if all criteria to receive an exemption are met the Town will provide a letter of exemption to the landowner. Before Any Demolition, Timbering or Clearing Begins Before any demolition, timbering, clearing or other land-disturbing activity begins, a preconstruction conference must be held with the owner/developer, the contractor implementing the plan and engineering department personnel. At this time, Land Disturbance Permit fees must be paid and a Land Disturbance Permit will be issued. In addition, tree protection must be installed prior to any work on the site. Tree protection measures will be inspected during the Certificate of Compliance Inspection. TOWN OF HOLLY SPRINGS ENGINEERING DEPARTMENT 128 South Main Street PO Box 8 Holly Springs, NC 27540 (919) 557-3938 FAX (919) 552-9881 www.hollyspringsnc.us

(Check All That Apply:) Application for Construction Drawing Approval Application for Erosion Control Plan Approval and Land Disturbance Permit ENGINEERING DEPARTMENT PO Box 8 Holly Springs, NC 27540 (919) 557-3938 FAX (919) 552-9881 Application for Timbering Plan Review & Permit Timbering Plan Forestry Activity Exemption 1. Project : Phase: 2. Brief Description of Timbering Activity: 3. Landowner(s) of Record: (Use additional pages if necessary and attach to application) Telephone Fax Telephone Fax Mobile Phone Pager Mobile Phone Pager 4. Future Landowner(s), If Applicable: (Use additional pages if necessary and attach to application) Telephone Fax Telephone Fax Mobile Phone Pager Mobile Phone Pager 5. List Book & Page where Deed or Instrument is Filed in Wake County: Book: Page: ; Book: Page: 6. Person(s) or Firm(s) Financially Responsible for Timbering Activity (Use additional pages if necessary and attach to application) Telephone Fax Telephone Fax

Application for Construction Drawing Approval Application for Erosion Control Plan Approval and Land Disturbance Permit Mobile Phone Pager Mobile Phone Pager 7. Registered Agent, if any, for Person(s) or Firm(s) Financially Responsible: (NOTE: A North Carolina agent is required if the applicant is not a resident of North Carolina.) Telephone Fax Mobile Phone Pager 8. Plans Prepared by: of Firm/Person Telephone Fax Mobile Phone Pager 9. Description of Location: Parcel Identification Number (PIN): Tax Map: Block: Lot: 10. Site/Project Information: Total Size of Tract: acres Area Disturbed: Acres ft 2 Watershed: Temporary Stream Crossing(s) Required? Riparian Buffers: linear feet Buffer Width feet Planning and/or Conservation Buffers Brief Description: 11. Timbering Plan Exemption: Please Circle One. Are you seeking an exemption from the Town s Timbering Plan Requirement? Yes / No Is the forestry activity is conducted pursuant to a forestry management plan or approved by a registered forester pursuant to Chapter 89B of the NC General Statutes? Is a copy of the forestry management plan prepared or approved by a registered forester provided with this application? Are affidavits provided by the landowner indicating the intent and scope of the timbering activity? 12. Approximate Date Tree Harvesting will begin: Yes / No Yes / No Yes / No

Application for Construction Drawing Approval Application for Erosion Control Plan Approval and Land Disturbance Permit 13. Signature and Witness: The above information is true and correct to the best of my knowledge and belief and was provided by me while under oath. Signature of Person Financially Responsible Type or Print Legibly Title or Authority I,, a Notary Public of the County of, hereby certify that personally before me this day and under oath acknowledged that this Application for Construction Drawing Approval/Application for Erosion Control Plan Approval and Land Disturbance Permit/ was executed by him or her. Witness my hand and notarial seal, this day of, 200 Date Signature of Notary Public My commission expires SEAL FOR OFFICE USE ONLY Date Completeness Verified: Project Number: PN- Fees Paid: Construction Drawing Review Fees Environmental Plan Review Fees