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� j STORMWATER MANAGEMENT PERMIT APPLICATION
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Submiss'ion of [his application co�stitWes notice that the projut si[e owner is npplying for coverage undec the Carmel City Code §6-18U
Ihrougli §6-209 for srormwnter discharges associated with co�struction activity disWrbing '/a acce or more of Iand. Pecmitted projut site
ownecs are requ¢ed ro comply with all terms and conditlons oP Ihe Ca[meI City Code.
A. The storm water quality meawres i�Guded i� the Stocm Walec PolWtion Preven[ion Plan (SWPPP) wmpiy with the requiceme�ts of
§6-180 through ¢6-209 of the Carmel Ciry Code, the City oi Carmel Stoc�nwater Technical Sta�dnrds Ma�ual, and all applicable
federal, atate, and local erocmwatec cequi�emenls;
B. The measuees req�ired by the Stocmwafer Pollution Prevention Plan (SWPPP) shall be implemented;
C. Sronnwa[er q�ality measures beyo�d those speciGed in Ihe SLo�mwaLer Pullution P�evention Plan (SWPPP) will be implemen[ed
during the life of the pacmit iCneceveary tu comply with the Cxrmei City Code; a�d
D. Imptementalion oC sto�mwater qualiry mea�ures will be i�spected by n'aineA individuuls;
8. Pucsuant to Caemel City Code §(r205, the City reserves the right to inepect and/or implement the s[ormweter quality measurea
outli�ed in the Stormwater Poll�tio� Preve�tion Plun (SWPPP) oe provide meintenance thereto, at my expense, if not perfonned.
!�' ," ST�F�II_ I�i �. �V OSS IZ I
SfgnaNre of P�oqect Owner Printed Name Date
Permit Approvcd: 8ngincering Depo�[mevt
Dme
Approval of ihis applicallon constim[cs eccepCance of thc Srorm Watcr Pollutio� Preventlon Plun (SW PPP) by @�e Ciry of Ca�mel.
By signing this application, I cenify the following: