"Civil Engineering Application for Projects Using 101 to 999 Scrap Tires and That Are No More Than 2 Bales High" - New Mexico

"Civil Engineering Application for Projects Using 101 to 999 Scrap Tires and That Are No More Than 2 Bales High" - New Mexico Download Pdf
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Civil Engineering Application for Projects Using 101 to 999 Scrap Tires and That Are No More Than 2 Bales High is a legal document that was released by the New Mexico Environment Department - a government authority operating within New Mexico.

Form Details:

  • Released on December 21, 2018;
  • The latest edition currently provided by the New Mexico Environment Department;
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Download "Civil Engineering Application for Projects Using 101 to 999 Scrap Tires and That Are No More Than 2 Bales High" - New Mexico

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NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
www.env.nm.gov/swb/
PERMIT APPLICATION
CIVIL ENGINEERING APPLICATION
USING 101 to 999 WHOLE TIRES or 1 to 9 TIRE BALES
In accordance with the New Mexico Recycling, Illegal Dumping and Scrap Tire Management Rule (20.9.20.10 and 20.9.20.13
NMAC), any person seeking to use more than 100 scrap tires in a civil engineering application that is two (2) bales high or less
shall first obtain a permit. The proposed structure and its temporary storage site must comply with the requirements of 20.9.20.36
and 20.9.20.37 NMAC. If the applicant has obtained an approval from the U.S. Army Corps of Engineers, then the following
information shall be submitted. To obtain the permit, complete the form below including all attachments
Assistance and
.
information may be obtained by contacting the Solid Waste Bureau’s Tire Program Coordinator at (505) 827-0559.
I.
ATTACHMENTS: PROVIDE THE FOLLOWING INFORMATION ON SEPARATE
PAGES AND ATTACH THEM TO THIS FORM:
A.
A copy of the deed or other legal description of the property on which the proposed civil
engineering application will be constructed.
B.
A detailed narrative description of the proposed civil engineering application, including a
set of plans signed and stamped by a registered New Mexico professional engineer.
C.
If the civil engineering application is to be in a floodplain, a waterway, or a wetland,
written authorization of the project by the U.S. Army Corps of Engineers or other appropriate authorities.
D.
A notarized affidavit, signed by a public official and the applicant, certifying that the
proposed site complies with the applicable regulations of all local governing bodies having jurisdiction
over the proposed facility, including planning, zoning, building, code enforcement and drainage
departments.
E.
A notarized affidavit, signed by the property owner and the applicant, approving the use
of scrap tires upon the property, shall be submitted as part of the permit application if the property owner
is different from the applicant.
II.
GENERAL INFORMATION:
A.
PROJECT TITLE:
B.
APPLICANT INFORMATION:
NAME
NEW MEXICO
ENVIRONMENT DEPARTMENT
Solid Waste Bureau
1190 Saint Francis Drive, Room N-2150
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
Telephone: (505) 827-0197 Facsimile: (505) 827-2902
www.env.nm.gov/swb/
PERMIT APPLICATION
CIVIL ENGINEERING APPLICATION
USING 101 to 999 WHOLE TIRES or 1 to 9 TIRE BALES
In accordance with the New Mexico Recycling, Illegal Dumping and Scrap Tire Management Rule (20.9.20.10 and 20.9.20.13
NMAC), any person seeking to use more than 100 scrap tires in a civil engineering application that is two (2) bales high or less
shall first obtain a permit. The proposed structure and its temporary storage site must comply with the requirements of 20.9.20.36
and 20.9.20.37 NMAC. If the applicant has obtained an approval from the U.S. Army Corps of Engineers, then the following
information shall be submitted. To obtain the permit, complete the form below including all attachments
Assistance and
.
information may be obtained by contacting the Solid Waste Bureau’s Tire Program Coordinator at (505) 827-0559.
I.
ATTACHMENTS: PROVIDE THE FOLLOWING INFORMATION ON SEPARATE
PAGES AND ATTACH THEM TO THIS FORM:
A.
A copy of the deed or other legal description of the property on which the proposed civil
engineering application will be constructed.
B.
A detailed narrative description of the proposed civil engineering application, including a
set of plans signed and stamped by a registered New Mexico professional engineer.
C.
If the civil engineering application is to be in a floodplain, a waterway, or a wetland,
written authorization of the project by the U.S. Army Corps of Engineers or other appropriate authorities.
D.
A notarized affidavit, signed by a public official and the applicant, certifying that the
proposed site complies with the applicable regulations of all local governing bodies having jurisdiction
over the proposed facility, including planning, zoning, building, code enforcement and drainage
departments.
E.
A notarized affidavit, signed by the property owner and the applicant, approving the use
of scrap tires upon the property, shall be submitted as part of the permit application if the property owner
is different from the applicant.
II.
GENERAL INFORMATION:
A.
PROJECT TITLE:
B.
APPLICANT INFORMATION:
NAME
MAILING ADDRESS
CITY, STATE, ZIP
TELEPHONE NUMBER
E-MAIL ADDRESS
C.
PROPERTY OWNER INFORMATION (if different):
NAME
MAILING ADDRESS
CITY, STATE, ZIP
TELEPHONE NUMBER
E-MAIL ADDRESS
D.
BUILDER INFORMATION (if different):
NAME
MAILING ADDRESS
CITY, STATE, ZIP
TELEPHONE NUMBER
E-MAIL ADDRESS
E.
LOCATION/PHYSICAL ADDRESS WHERE PROJECT WILL BE CONSTRUCTED
(including GPS coordinates, as determined by a geographic information system unit or survey):
F.
TEMPORARY STORAGE SITE INFORMATION (this section must be completed if
tires or bales will be stored prior to construction at a temporary storage site):
LOCATION/PHYSICAL ADDRESS (including GPS coordinates)
PROPERTY OWNER NAME (if different)
PROPERTY OWNER MAILING ADDRESS
- 2 -
CITY, STATE, ZIP
PROPERTY OWNER TELEPHONE
PROPERTY OWNER E-MAIL ADDRESS
III.
OPERATIONS:
A.
ANTICIPATED START DATE WHEN SCRAP TIRES WILL BE BROUGHT TO
PROJECT SITE:
B.
PROJECTED COMPLETION DATE OF PROJECT:
C.
ORIGIN(S) OF SCRAP TIRES OR TIRE BALES TO BE USED:
D.
THE NUMBER OF SCRAP TIRES OR TIRE BALES TO BE USED IN THE PROJECT
(please specify if loose tires or tire bales will be used):
E.
METHOD OF STACKING:
F.
METHOD OF ANCHORING:
G.
METHOD OF COVERING (if applicable):
H.
METHOD OF FILLING TIRES (if whole tires):
- 3 -
IV.
CERTIFICATION:
THE UNDERSIGNED ATTESTS THAT THE INFORMATION PROVIDED UPON THIS
REGISTRATION FORM, INCLUDING ALL ATTACHMENTS, IS TRUE AND CORRECT.
SIGNATURE
DATE
RETURN THIS FORM and the REQUIRED ATTACHMENTS TO:
William (“Bill”) W. Myers
Tire Program Coordinator
NMED Solid Waste Bureau
1190 St. Francis Drive, Room N-2150
P.O. Box 5469
Santa Fe, New Mexico 87502-5469
Application for Small Civil Engineering Application Permit - Revised 12/21/2018
- 4 -
New Mexico Environment Department New Mexico Legal Forms United States Legal Forms

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"Civil Engineering Application for Projects Using 101 to 999 Scrap Tires and That Are No More Than 2 Bales High" - New Mexico Download Pdf
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