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Home My WebLink AboutMCWD Permit 15-335 MINNEHAHA CREEK � WATERSHED DISTRICT QUALITY OF WATER "�'� QUALITY OF LIFE Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements The Minnehaha Creek and information contained in the permit application, correspondence, plans, Watershed Districtis maps, and all other supporting data submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant committed to a leadership named below for use and development of land in the Minnehaha Creek Watershed District. role in protecting, improving and managing Issued to: James F. Hillier Permit No: 15-335 the surface waters and Location: 1224 Briar Street, Orono affiliated groundwater resources within the Purpose: Erosion Control, Sinqle Family Home District,including their Date of Issuance: 7/17/2015 Date of Ex iration: 7/17/2016 relationships to the By Order of the Board of Managers ecosystems of which ^ � � I � they are an integral part. Tom DietriC We achieve our mission DistriCt TeChniCian through regulation, This permit is not transferable without District approval, and is valid to the date of expiration. No activity is authorized beyond the expiration date. If the permittee capital projects, requires more time to complete the project, an application for renewal of the education,cooperative permit must be received by the District at least 30 days before expiration. endeavors,and other The applicant is responsible for compliance with all District Rules and for the action of their representatives, contractors, and employees. programs based on sound saence, Conditions: Project to be completed as described in plans submitted to the MCWD office on July 6th, 2015 according to the provisions of this innovative thinking,an permit. informed and engaged • Properly install and maintain all required erosion control measures until the disturbed areas are re-stabilized constituency,and the • Notify MCWD in writing upon completing installation of perimeter and sedimentation controls cost effective use of . When the site is re-stabilized and the MCWD staff has public funds. performed a final inspection, all silt fences must be removed (Statement concerning fees for inspections, violations, etc... on following page) 15320 Minnetonka BouLevard, Minnetonka, MN 55345 • OfFice: (952)471-0590• Fax: (952)471-0682 • www.minnehahacreek.org MINNEHAHA CREEK WATERSHED DISTRICT � QUALITY OF WATER "'"'�- QUALITY OF LIFE Inspection/Analvsis/Monitorinq Fees The Minnehaha Creek Watershed District is A site inspection and monitoring by District staff will be performed where the committed to a leadership activity involves: rote in protecting, � a commercial/industrial/multi-family residential development improving and managing • a single family residential development greater than 5 acres or of any size if within the Minnehaha Creek subwatershed the surFace waters and . any alteration of a floodplain or wetland afFiliated groundwater • dredging within the beds, banks or shores of any protected water or wetland • a violation resources within the . any project which in the judgment of the District staff should be inspected District,including their due to project location, scope, or construction techniques relationships to the In these cases, the applicant shall pay to the District a fee equal to the actual ecosystems of which costs of field inspection of the work, including investigation of the area affected they are an integral part. by the work, analysis of the work, and any subsequent monitoring of the work, which in the case of a violation shall be at least $35. We achieve our mission through regulation, capital projects, Standard Fee Schedule education,cooperative District professional staff $ 65.51* District interns $ 40.35* endeavors,and other District clerical staff $ 46.69* programs based on Consulting Senior Engineer $ contracted rate Consulting Engineer/Technician $ contracted rate sound sdence, District Counsel $ contracted rate innovative thinking, an Application fee $ 10.00 Copy costs $ .25 + actual staff time informed and engaged Color copy costs $ 1.00 + actual staff time constituency,and the cost effective use of * Hourly public funds. 15320 Minnetonka Boulevard, Minnetonka, MN 55345 • Office: (952) 471-0590• Fax: (952) 471-0682 •www.minnehahacreek.org l.�.__._�,------ WATER RESOURCE PERMIT APPLICATION FORM Use this form to notify/apply to the Minnehaha Creek Watershed District(MCWD)of a proposed project or work which may fall within their jurisdiction. Fill out this form completely and submit with your site plan,maps,etc.to the MCWD at: 15320 Minnetonka Blvd.Minnetonka,MN 55345. Keep a copy for your records. YOU MUST OBTAIN ALL REQUIRED AUTHORIZATIONS BEFORE BEGINNING WORK. 1. Name of each property owner: ,��,- � ,��c- Mailing Address: %Z z y ,��l.fi� ��2� �� City:� G'��,J� State: .t%k.�' Zip:,�.��`t� Email Address: �=�'; . f�`<<.�4� �/,��zs�y�j��. ��. Phone: �iz -��(��-�;3 7 y Fax: -- 2. Property Owner Representative Information (not required) (licensed contractor, architect, engineer, etc...) Business Name: Representative Name: Business Address: � City: State: Zip: Email Address: Phone: Fax: 3. Project Address: z :�.`�.,,z S:�-4�� City: C>,2-o,.;c� State: /�9,�'' Zip: ,S 3'�� Qtr Section(s): Section(s): Township(s): Range(s): Lot: 1��lock: �� Subdivision: /61��„��;-�� ,g,�� '�cys%n��y PID:/�a ---/��-2�-�1 -UL��-( 4. Size of project parcel (square feet or acres): �C�,,S c-'�' Area of disturbance (square feet): j,��; �� i- T. Volume of excavation/fill (cubic yards): Area of existing impervious surface: Area of proposed impervious surface: Length of shoreline affected (feet): �u�,� Waterbody (& bay if applicable): ,��•�� 5. Type of permit being applied for(Check all that apply): � EROSION CONTROL ❑ WATERBODY CROSSINGS/STRUCTURES ❑ FLOODPLAIN ALTERATION ❑ STORMWATER MANAGEMENT ❑ WETLAND PROTECTION ❑ APPROPRIATIONS ❑ DREDGING ❑ ILLICIT DISCHARGE ❑ SHORELINE/STREAMBANK STABILIZATION 6. Project purpose (Check all that apply): �j SINGLE FAMILY HOME ❑ MULTI FAMILY RESIDENTIAL (apartments) ❑ ROAD CONSTRUCTION ❑ COMMERCIAL or INSTITUTIONAL ❑ UTILITIES ❑ SUBDIVISIONS (include number of lots) ❑ DREDGING ❑ LANDSCAPING (pools, berms, etc.) ❑ SHORELINE/STREAMBANK STABILIZATION ❑ OTHER(DESCRIBE): � 7. NPDES/SDS General Stormwater Permit Number(if applicable): 8. Waterbody receiving runoff from site: 9. Project Timeline: Start Date: Completion Date: Permits have been applied for: City �County �MN Pollution Control Agency � DNR �COE � Permits have been received: City �County �MN Pollution Control Agency �DNR �COE � By signing below,I hereby request a permit to authorize the activities described herein. I certify that I am familiar with MCWD Rules and that the proposed activity will be conducted in compliance with these Rules. I am familiar with the information contained in this application and,to the best of m,y knowledge and belief, all information is true, complete and accurate. 1 understand that proceeding with work before all required authorizations are obtained may be subject to federal, state and/or local administrative, civil and/or crimirial�penadti�s. �;`-, ,--�� J � ��. �� , � s Signature of Each Property��Owner Date ��s�� i`�� ;'1; � ; 1'.tt'�t 1 ��f' 1 ' �—�� — :��+—�---�—.�' .i ��, �� a a,_j �� `�R�E�C E�I�P�JT DATE -�, � l� � N o. � � � ;� �W; RECEIVED FROM � U vY�-P� `�� I� �� f � P v' �. .i� �, r� / ��/U�� ___ DOLLARS �FORRENT ' 1�w'� ?-�L'� ��v�� 1 G�.( �� ACGOUNT O CASH � ��'� O CHECK " FROM TO PAYMENT MONEY O ORDER ' BAL.DUE O CREDIT CARD BY 3-�� 75-1523 JAMES F'.HILLIER 960 " 14 8 9 5 1224 BRIAR ST. WAYZATA,MN 55391 -� � DATE � PAY TO �� o THE ORDER O� �1` a �`; e;/ ��. \ . _. [apLLARS LJ o."�°a„e.� ° ANCHOR Q BANK� www.anchorlink.com AnchorLine�952-808-8083 /' / MEMO �' j�� NP �:0960 L5 23 2�:006065 L89�i' 14'&9"5