Spreadsheet: 2304f482-77a2-46a4-86aa-63f48e9103be
Sheet: Sheet1

Red triangles at the upper right hand corner indicate design comments | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4
Please complete the yellow shaded items.
STORMWATER MANAGEMENT PERMIT APPLICATION FORM
401 CERTIFICATION APPLICATION FORM
WETLAND SUPPLEMENT
This form must be filled out, printed and submitted.
The Required Items Checklist (Part III) must be printed, filled out and submitted along with all the required information.
I.  PROJECT INFORMATION
Project name
Contact name
Phone number
Date
Drainage area number
II.  DESIGN INFORMATION
Site Characteristics
Drainage area |  | ft2
Drainage area |  | acres
Impervious area |  | ft2
Impervious area | 0 | acres
Percent impervious |  | %
Design rainfall depth |  | inch
Peak Flow Calculations
1-yr, 24-hr rainfall depth |  | in
1-yr, 24-hr intensity |  | in/hr
Pre-development 1-yr, 24-hr runoff |  | ft3/sec
Post-development 1-yr, 24-hr runoff |  | ft3/sec
Pre/Post 1-yr, 24-hr peak control |  | ft3/sec
Large Design Storm
Design Storm to control |  | yr
 |  | hr
Rainfall intensity, large design storm | 0 | in/hr
Peak flow, large design storm |  | ft3/sec
Length of overflow weir |  | ft
Storage Volume:  Non-SA Waters
Minimum required volume |  | ft3
Volume provided (temporary pool volume) |  | ft3
Storage Volume:  SA Waters Parameters
1.5" runoff volume |  | ft3
Pre-development 1-yr, 24-hr runoff volume |  | ft3
Post-development 1-yr, 24-hr runoff volume |  | ft3
Minimum volume required |  | ft3
Volume provided |  | ft3
Outlet Design |  |  | 0
Depth of temporary pool/ponding depth (DPlants) |  | in | 1
Drawdown time |  | days | 0
 |  |  | 0
 |  |  | 0
 |  |  | 0
Diameter of orifice |  | in
 |  | 0
 |  | 0
Coefficient of discharge (CD) used in orifice diameter calculation |  | (unitless)
Driving head (Ho) used in the orifice diameter calculation |  | ft | 0
Surface Areas of Wetland Zones |  |  | 0
Surface Area of Entire Wetland |  | ft2
Shallow Land |  | ft2
The shallow land percentage is: |  | %
Shallow Water |  | ft2
The shallow water percentage is: |  | % | 0
 |  |  | 0
 |  |  | 0
[NAME]
[NAME] portion of deep pool (pretreatment) |  | ft2
The forebay surface area percentage is: |  | %
 |  |  | 0
Non-forebay portion of deep pool |  | ft2
The non-forebay deep pool surface area percentage is: |  | %
Total of wetland zone areas | 0 | ft2 | 2
 |  |  | 3
Add or subtract the following area from the zones | 0 | ft2
Topographic Zone Elevations
Temporary Pool Elevation (TPE)
Shallow Land (top) |  | ft amsl
Permanent Pool Elevation (PPE)
Shallow Water/Deep Pool (top) |  | ft amsl | 0
Shallow Water bottom |  | ft amsl
Most shallow point of deep pool's bottom |  | ft amsl
Deepest point of deep pool's bottom |  | ft amsl
Design must meet one of the following two options:
This design meets Option #1,  Top of PPE is within 6" of SHWT, If yes: |  | (Y or N)
 | 0
SHWT (Seasonally High Water Table) |  | ft amsl | 0.5 | OK
This design meets Option #2,  Wetland has liner with permeability < 0.01 in/hr, If yes: |  | (Y or N)
Depth of topsoil above impermeable liner |  | in | 1
 |  |  | 1
Topographic Zone Depths
Temporary Pool
Shallow Land | 0 | in | 1
 |  |  | 0
 |  |  | 0
Permanent Pool
Shallow Water | 0 | in | 1
 |  |  | 0
 |  |  | 0
[NAME] (shallowest) | 0 | in | 0
 |  |  | 0
 |  |  | 0
[NAME] (deepest) | 0 | in | 0
 |  |  | 0
 |  |  | 0
Planting Plan
Are cattails included in the planting plan? |  | (Y or N)
Number of Plants recommended in Shallow Water Area:
Herbaceous (4+ cubic-inch container) | 0
Number of Plants recommended in Shallow Land Area:
Herbaceous (4+ cubic-inch container), OR | 0
Shrubs (1 gallon or larger), OR | 0
Trees (3 gallon or larger) and [NAME] (4+ cubic-inch) | 0 | and |  | 0
Number of Plants provided in Shallow Water Area:
Herbaceous (4+ cubic-inch container)
Number of Plants provided in Shallow Land Area:
Herbaceous (4+ cubic-inch container)
Shrubs (1 gallon or larger)
Trees (3 gallon or larger) and
Grass-like Herbaceous (4+ cubic-inch)
Additional Information
Can the design volume be contained? |  | (Y or N)
Does project drain to SA waters?  If yes, |  | (Y or N)
What is the length of the vegetated filter? |  | ft
Are calculations for supporting the design volume provided in the application? |  | (Y or N)
Is BMP sized to handle all runoff from ultimate build-out? |  | (Y or N)
Is the BMP located in a recorded drainage easement with a  recorded access easement to a public Right of Way (ROW)? |  | (Y or N)
The length to width ratio is: |  | :1
Approximate wetland length |  | ft
Approximate wetland width |  | ft | 0
Approximate surface area using length and width provided | 0 | ft2 | 0
Will the wetland be stabilized within 14 days of construction? |  | (Y or N)