NC Department of Environment and Natural Resources
Land Resources - Forms

Land Resources

Forms, checklists, notices and guidelines

Forms, checklists, notices and guidelines

This page provides required forms, listed by Land Quality Section program (Erosion and Sedimentation Control, Dam Safety, and the Mining Program). Click on any active link. Two formats are offered (MS Word and PDF).

Fillable Adobe Acrobat forms are being introduced beginning with the Dam Safety program. They can be completed and printed locally for mailing. However, Adobe Acrobat Writer (preferably Professional 7.0) can be used to save files and to email them as attachments. Fillable forms are denoted as 'PDF - fillable'.

Contents - Click on program of interest for forms

Erosion and Sedimentation Control (forms, checklists, notices)
Dam Safety (forms, checklists, guidelines, Emergency Application Plan shell documents)
Mining Program (forms, checklists)

Erosion and Sedimentation Control

Plan review flowchart (PDF only)
Financial responsibility / ownership - 1 August 2007 (MS Word, PDF)
Notice
- Notice of Plan Review Fee - 1 August 2007 (MS Word, PDF)
- Ground cover (MS Word, PDF)
DENR express permitting option
Express review - general process - 30 April 2007 (MS Word)
Express review - guidance document - 13 May 2008 (MS Word)
Express review - financial responsiblity form - 1 August 2007 (MS Word, PDF)
Plan check list for designers - 19 February 2009 (MS Word,PDF)

Dam Safety

Plan review flowchart (PDF only), repair/renovation flowchart (in preparation)
Determination if a dam is governed by the Dam Safety Act (as Amended) (MS Word, PDF- static version, PDF fillable)
Dam Hazard Classification Data Form (MS Word, PDF - static; PDF fillable)
Owner's Certification (cost certification) (MS Word, PDF - static version; PDF fillable)
Check lists
- Dam Safety (MS Word, PDF)
- SEPA Dam Safety (MS Word, PDF)
Guidelines
- Owner's fee determination guidelines (MS Word, PDF)

Mining Program

Permit process flowchart (PDF only)
Mining permit application (MS Word) - Download this MS Word file to your computer before beginning to fill it out
Mining release (MS Word, PDF)
Assignment of Savings Account (MS Word, PDF)
Irrevocable Standby Letter of Credit (MS Word, PDF)
Surety Bond (MSWord, PDF)
Annual reclamation report for 2011 (MS Word, PDF)
Check lists
- Full release (MS Word, PDF)
- Partial release (MS Word, PDF)
- Modification (MS Word, PDF)
- Renewal (MS Word, PDF)
- Transfer (MS Word, PDF)
Guidelines
- Reclamation bond guidelines (MS Word, PDF)

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N.C. Department of Environment and Natural Resources

1601 Mail Service Center, Raleigh, NC 27699-1601 USA

Headquarters (Environment and Natural Resources Building): 217 W. Jones St.

Archdale Building: 512 N. Salisbury St.

Toll Free: (877) 623-6748

NC Department of Environment and Natural Resources
Land Resources - Forms

Land Resources

Land Quality

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