The Material Source Approval Request form, employed by the North Dakota Department of Transportation's Office of Environmental and Cultural Resources, serves as a vital procedural document aimed at regulating the extraction and use of materials from specific locations. This comprehensive form, identified by the State Form Number 58466 and last updated in February 2009, necessitates detailed submissions for each material source location. Applicants must provide a wealth of information, including a precise legal description, a pit ID for department use, submission date, and the geographical specifics such as county, township, range, and section. It specifically asks for the type of material or activity intended at the site, ranging from aggregate, borrow, and stockpile areas to rip-rap, plant, and waste sites, alongside the approximate depth of excavation. Each request mandates personal and project-related details, including the name and contact of the project engineer or manager, the consulting engineering firm involved, project numbers, and pertinent contact information for both the applying company and its key contact person. This form underscores a thorough vetting process, highlighted by a requisite map attachment for area approval, promising a systematic and environmentally conscious approval process. Additionally, it underscores the collaborative aspect of the approval process by incorporating a section for the U.S. Fish and Wildlife Service (USFWS), underscoring the importance of considering protected species and habitat. The necessity for at least a 30-day processing period is indicated, alongside instructions for submission, thereby setting clear expectations for all parties involved.
Question | Answer |
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Form Name | Material Approval Form |
Form Length | 3 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 45 sec |
Other names | material approval request letter, material sample approval form, material approval request template, material approval form |
MATERIAL SOURCE APPROVAL REQUEST
North Dakota Department of Transportation, ETS - Environmental and Cultural Resources
SFN 58466
Complete a separate form for each material source location The following information is REQUIRED
(including map file showing boundary of area to be approved)
Legal Description
Pit ID (NDDOT Use Only)
Date Submitted
FEB 25, 2009
County
McLean
Township (number, not name)
149
RangeSection
08335
Material/Activity Check all that apply
Aggregate |
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Staging Area |
Borrow |
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Stockpile Area |
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Plant Site |
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Waste Site |
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Approximate Depth of Excavation
Source Name
site 1
Project Information
Name (Project Engineer or Project Manager) |
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Division/District/Consulting Engineering Firm |
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Joe Designer |
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No Name Engineering |
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Project Number or Project Location |
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Project Control Number |
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Email Address |
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15151 |
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jdesigner@noname.com |
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Applicant
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Company Name |
Contact Person |
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Yankee Excavating |
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Bernie Williams |
Address
44 East 16 st St.
Telephone Number
City |
State |
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Zip Code |
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New York |
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NY |
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10451 |
Email Address
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idig@excavating.com |
Comments
NENE
Please allow at least 30 days for completion of this process
YOU MUST ATTACH A MAP or the form will be returned to you!
Print or save a copy for your own records!
Submit by email to: materialsource@nd.gov
USFWS Use Only
USFWS Property
T&E Species Further Review Required
USFWS Approval
Date
USFWS
Comments
101°16'W |
101°15'W |
27
34
5
26
Haul Road
Area to be disturbed
T149N
R 83W
35
MCLEAN
T148N |
4 |
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R 83W |
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25
36
3
47°41'N
101°16'W |
101°15'W |
F
101°16'W |
101°15'W |
27
34
5
26
Haul Road
Area to be disturbed
T149N
R 83W
35
MCLEAN
T148N |
4 |
|
R 83W |
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25
36
3
47°41'N
101°16'W |
101°15'W |
F