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2. Address or Location of work to be performed
4. First & Last Name of Property Owner(s)
5. Property Owner Address
7. City
8. State
9. Zip Code
11. Phone Number
12. Email Address
16. Contractor Business Name
17. Address
19. City
20. State
21. Zip Code
23. Phone Number
24. Email Address
28. Will excavated material be leaving the site?

    1. Yes
    2. No
29. Where will it be deposited?
31. Will fill material be brought on site?

    1. Yes
    2. No
32. Where will it come from?
34. Give a brief description on existing terrain, native vegetation and improvements on project site.
36. Permittee must have stabilization controls in place and inform new property owner of their responsibilities before turning over to new property owner.
    Permittee must have stabilization controls in place and inform new property owner of their responsibilities before turning over to new property owner.

    Date for final stabilization: 

40. Does this site contain/border any of the following? Check all that apply.

    1. Stream
    2. Lake
    3. Wetland
42. Is the project site located within an identified 100 year floodplain?

    1. Yes
    2. No
44. Total Land Disturbance

    1. 1,000 square feet to less than 1/2 acre ($50)
    2. 1/2 acre to less than 1 acre ($100)
    3. 1 acre or more ($150)
48. A grading and erosion control plan or storm water pollution prevention plan must be submitted with this application for approval. Please allow two weeks for approval. The permit is issued for a period of one year from the date of issuance and may be renewed upon inspection and approval.
50. Upload Plan Here
52. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, 3) you may still be required to provide a traditional signature at a later date, and 4) by typing your name into the field available you are hereby authorizing Spearfish, South Dakota to accept this as your electronic signature and as an agreement to follow all applicable rules, laws and ordinances.

    1. I agree.
54. Electronic Signature
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit

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