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Home My WebLink AboutMCWD permits t� � i'\ � i� MINNEHAHA CREEK -� �°� WATERSHED DISTRICT QUALITY OF WATER "�°�''� QUALITY OF LIFE Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information contained in the permit application, correspondence, plans, The Minnehaha Creel< maps, and all other supporting data submitted by the applicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant �Vatershed Distr'ct is named below for use and development of land in the Minnehaha Creek comr�itted to a teadErsr�;p Watershed District. role in protecting, Issued to: Mark Huerung Permit No: 11-216 improving and managir.g the surFace wa±ers an� Location� 3315 Graham Hill Road Orono affiliated grcundU�ater Purpose: Erosion Controi — Sinqle Family Home resources tivithin tt,e Date of Issuance: 8/1/2011 Date of Ex iration: 8/1/2012 District,induding their By O f th oar of Managers relationships to ti�e ecosystems or which Catherine Bach they are an int�grat p�rt. District Technician lNe achieve our mission 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 through regulation, requires more time to complete the project, an application for renewal of the capital projects, permit must be received by the District at least 30 days before expiration. education,cooperati��e The applicant is responsible for compliance with ali District Rules and for the endeavors,an�other action of their representatives, contractors, and employees. � programs based on Conditions: Project to be completed as described in plans submitted to the ; MCWD office on July 29, 2011 according to the provisions of this sound science, permit. innovative thinking, an • Properly install and maintain all required erosion control i measures until the disturbed areas are re-stabilized � informed and engaged • When the site is re-stabilized and the MCWD staff has perFormed a final inspection, all silt fences must be removed eonstituency, and the �'i cos�efrective use af pub�;c�n�:s. (Statement concerning fees for inspections, violations, etc... on following page) I 18202 Minnetonka Boulevard, Deephaven, MN 55391 •Office: (952)471-0590• fax: (952) 471-0682 •www.minnehahacreek.org l �� , MINNEHAHA CREEK ��,�� WATERSHED DISTRICT QUALITY OF WATER - � `�-�`� QUALITY OF LIFE Inspection/Analvsis/Monitorinq Fees The f�linnehaha Cree� A site inspection and monitoring by District staff will be performed where the activity involves: Watershed District is • a commercial/industrial/multi-family residential development comnzitted to a leadersh�,� � a single family residential development greater than 5 acres or of any size if role in p�otecrnq, within the Minnehaha Creek subwatershed • any alteration of a floodplain or wetland improving and inanacinG . dredging within the beds, banks or shores of any protected water or wetland the s�rface�,�aters and • a violation • any project which in the judgment of the District staff should be inspected due affitiated groundv:�ater to project location, scope, or construction techniques resources within tre District,including their In these cases, the applicant shall pay to the District a fee equal to the actual costs of field inspection of the work, including investigation of the area affected relationships to tre by the work, analysis of the work, and any subsequent monitoring of the work, ecosystems of whicn Which in the case of a violation shall be at least $35. they are an integral pa�*. We achieve our mission Standard Fee Schedule through regutation, District professional staff $ 55.79" cap;ta�proje�" District interns $ 34.24* District clerical staff $ 50.40* education,coarer3r,vz Consulting Senior Engineer $ contracted rate endeavcrs,and other Consulting Engineer/Technician $ contracted rate District Counsel $ contracted rate proyrams based cn Application fee $ 10.00 Copy costs $ .25 + actual staff time sound sdence, Color copy costs $ 1.00 + actual staff time innovative thinking,an informed and engaged * Hourly constituency,and the cost effective use ef public funds. 18202 Minnetonka Boulevard, Deephaven, MN 55391 • OfFice: (952)471-0590• Fax: (952)471-0682 •www.minnehahacreek.org l WATER RESOURCE PERMIT APPLICATION-COMBINED JOINT NOTIFICATION FORM Use this form to notify/apply to the Minnehaha Creek Watershed District(MCWD),their engineering consultants,and the DNR of a proposed project or work which may fall within their jurisdiction.These agencies should advise you of their jurisdiction or permit requirements within 10 days.Fill out this form completely and maii with your site plan,maps,etc...to the MCWD, 18202 Minnetonka Boulevard,Deephaven,MN 55391.Keep a copy for your records. YOU MUST OBTAIN ALL REQUIRED AUTHORIZATIONS BEFORE BEGINNING WORK. 1.Property Owner Name(First,Last): Y1't��rk l verun j� Mailing Address: 2ZS �� .5�. 5_ �Z�oc� City:'71'I�nr�.�pc:l�� State: /'`�,l� Zip: SS�c�'L Email Address: '��'►a�' -he�.�v;� ;@n - ��r� Phone:�.-��?-�[.cc F�: 2.Location of proposed project(Attach p wit d' ections to site): ProjectAddress: 33►� (;�ahavr ��;�� City: �r4;�� County: �H�:�r��o;'� Qtr Section(s): Section(s): Township(s): Range(s): Lot: G� Block: � Subdivision: t=�•�►�� z�-YVP PID: 3. Size of site: l 3 3.� 3� F . Area of disturbance: — square feet,or -7� acres Volume of excavation(or fill): cubic yards Length of shoreline affected: �%%A feet Area of existing impervious surface: � Area of proposed impervious surface: 4. Type of permit being applied for(Check all that apply): � EROSION CONTROL �WETLAND ALTERATION � STORNIWATER MANAGEMENT �WATERBODY CROSSING � FLOODPLAIN ALTERATION �SHORELINE/STREAMBANK IlVIPROVEMENTS ❑ DREDGING � OTHER(DESCRIBE): 5.Project Purpose(Check all that apply): � SINGLE FAMILY HOME ❑MULTI FAMII,Y RESIDENTIAL HOUSING(apartments,etc.) � COMMERCIAL CONSTRUCTION �INSTITUTIONAL CONSTRUCTION(churches,schools,etc.) � ROAD CONSTRUCTION �SUBDNISIONS(include number of lots) 0 UTII,ITIES OLANDSCAPING(pools,berms,etc.) ❑ DREDGING �SHORELINE STABILIZATION(lakescaping,bioengineering) � OTHER(DESCRIBE): 6.NPDES/SDS General Stormwater Permit number(if applicable): /�//A 7.Alternatives(Describe any other sites or methods that could be used to avoid or minimize impacts to water bodies to achieve the project purposed.Attach additional sheet ifneeded.) 8.Project Timeline: Start Date: J✓I � Z�;Z�'ii Completion Date: A ;•�1,�olL 9.Applicants Representative/J(Licensed contractor,engineer, etc...) Business Name: Lh.�rGc7 (�LY��) �-l�Ic,�v� Representative Name: :Ir��, �: ��,z BusinessAddress: i5� �� 3"`'A� �- Cit f( �nc✓T� State: MN Zi Y� ti, P� 5'��7 Email Address: `,ir, I C'cliarG-s�,.�►J ��:.r. Phone: ��Z'u��--`I-h y5� Fax: G�L-�:��-1 z3`i 10.Names and ad resses o adjoining property owners(Attach list if nec/.e�ssa L��'� 1'/.d�l Lv_lil: -�"dr�2r�� IL.I ? � I��T�^II.�r1� 3377 Gc,ha�r �+�1� f� 32�'�� Liahzr,r. 1-�',�� c). 34i5 , �� L��.�. Permits have been applied: City � County � MN Pollution Control Agency � DNR � COE� Permits have been received:City � County � MN Pollution Control Agency � DNR � COE � I hereby notify the recipients of this form of the project proposed herein and request I be advised of any permits or other determinations concerning this project that I must obtain.I understand that proceeding with wark before all required authorizations are obtai d may be subject to Federal,State and/or local administrative,civil and/or criminal penalties. 7��qlt� Sig ature ofProper� wner Date—' T Page 1 of2 I INSTRUCTIONS—PLEASE READ CAREFULLY A copy ofthis form,with wpies of all plans,drawings,etc...may need to be sent to an agency indicated below...Please check the appropriate spaces below to show everytivhere you are sending this form.Remember to keep a copy far your records. � MINNESOTA POLLUTION CONTROL AGENCY(MPCA)for NPDES phase II permit � 'I'he LOCAL GOVERNMENTAL iJNIT(LGU),city,county or water management organization �MINNESOTA DEPARTMENT OF NATURAL RESOURCES(MDNR)Regional Office 0 US ARMY CORPS OF ENGINEERS(ACOE)at Dept.ofthe Army,Corps of Engineers,St.Paul District ATTN:CO-R, 190 Fifth St.East,St.Paul,MN 55101-1638 I�iote:The above Agencies may provide a copy of your completed form to the Minnesota Pollution Controi Agency(MPCA). MPCA water quality requirements may apply to your proposed project. ATTENTION(from USDAI:Any activity including drainage,dredging,filling,leveling or other manipulations,including maintenance, may affect a land user's eligibility for USDA benefits under the 1985 Food Security Act as amended.Check with }�our local USDA office to request and complete Form AD-1026 prior to initiating activity. Application is hereby made for 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 containerl in this application and,to the best of my knowledge and belief,all information is true,complete and accurate.I further certify that I possess the authority to undertake the proposed activity or I am acting as the duly authorized agent of the applicant. � ? �l ��2�►��1 , ��r� '1 �9 ��:r� Sig reofApplica t ropertyOwner) Dat--�e ` ' Si natur�ofA ent Date g g NOTE:The application must be signed by the property owner where the proposed activity is to occur.The application may be signed by a duly authorized agent if a letter bearing the original signature of the property owner is submitted stating that the agent noted in the permit application is the authorized agent of the landowner for all matters relating to the permit.Please provide authorized agent information below: Agent's Name&Title: ��avne� �'11 r�� r�t..k'�-'�r.i-. ��X7 :S-�,�.T�►xS ��' � -- ' P� t� , �,� Agent's Address: �5��`w 2�� , ��rLv 5��f�F) Agent's Telephone: t�( I Z ) �-tt"3— �E:'9� 18 U.S.C.Section 1001 provides that:Whoever,in any manner within jurisdiction ofany department or agency of the United States knowingly and willfully falsifies,conceals or covers up by any trick,scheme,or device a material fact or makes any false, fictitious or fraudulent statements or representations or makes or uses any false writing document knowing same to contain any false, fictitious,or fraudulent statement or entry,shall be fined not more than$10,000 or imprisoned not more than five years,or both. 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