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Home My WebLink AboutMCWD permit , MINNEHAHA CREEKWATERSHED DISTRICT on QUALITY OF WATER _Y. QUALITY OF LIFE Pursuant to Minnesota Statutes Chapter 103D, and on the basis of statements and information contained in the permit application, correspondence, plans, maps, and all other supporting data submitted by the apIicant, and made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant named below for use and development of land in the Minnehaha Creek Watershed Di trict. 2O1(o • a 5r Issued to: David Nem & Julia Shaver Permit No: 16-346 Location: 40 Oror o Orchard Rd. Orono Purpose: Erosion(Control. Landscaping Date of Issuance: 7/98/2016 Date of Expiration: 7/08/2017 By Order of the Board of Managers 4' ik.A,v 7VA ((rk- l- -"' meld! Quinn Permitting Technician This permit is not tra sferable without District approval, and is valid to the date of expiration. No activity is authorized eyond the expiration date. If the permittee requires more time to complete the project, an applic tion for renewal of the permit must be received by the District at least 30 days before expiratio . The applicant is respnsible for compliance with all District Rules and for the action of their representatives, cont actors, and employees. Conditions: Project to be completed as described in plans submitted to the MCW office on June 23, 2016 according to the provisions of this permit. • Properly install and maintain all required erosion control measures until the disturbed areas are re-stabilized • N ify MCWD in writing upon completing installation of perimeter and se imentation controls • Wen the site is re-stabilized and the MCWD staff has performed a final inspection, all perimeter control must be removed (Statement qoncerning fees for inspections, violations, etc... on following page) We collaborate with public and private partners to protect and improve land and water for current and future generations. 15320 Minnetonka Boulevard,Minnetonka,MN 55345 • (952)471-0590 • Fax:(952)471-0682 • www.minnehahacreek.org . , MINNEHAHA CREEK WATERSHED DISTRICT QUALITY OF WATER Y' QUALITY OF LIFE Inspection/Analvsis/Monitoring Fees A site inspection an monitoring by District staff will be performed where the activity involves: • a commercial/in ustrial/multi-family residential development • a single family r idential development greater than 5 acres or of any size if within the Minnehaha Cree subwatershed • any alteration of floodplain or wetland • dredging within the beds, banks or shores of any protected water or wetland • a violation • any project which in the judgment of the District staff should be inspected due to project location, scope, or construction techniques 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 by the work, analysis of the work, and any subsevent monitoring of the work, which in the case of a violation shall be at least$35. Standard Fee Schedule District professional staff $ 65.51* District interns $ 40.35* District clerical staff $ 46.69* Consulting Senior Ergineer $ contracted rate Consulting Engineerllechnician $ contracted rate District Counsel $ contracted rate Application fee $ 10.00 Copy costs $ .25 + actual staff time Color copy costs $ 1.00 + actual staff time • Hourly We collaborate with public and ivate partners toprotect and improve land and water for current and future generations. P P 15320 Minnetonka Boulevard,Minnetonka,MN 55345 • (952)471-0590 • Fax:(952)471-0682 • www.minnehahacreek.org 34rg; (1)600 .11N 2 3 2016 WATER RESOURCE PERMIT APPLICATION FORM Use this form to notify/apply to the Minnehaha Creek Watershed District(MCWD)of a proposed project arc, 1,� y fall within their jurisdiction.Fill out this form completely and submit with your site plan,maps,etc.to the i aE'' 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: David Klema and Julia Shaver Mailing Address: 40 Orono Orchard Rd City: Orono State: MN Zip: 55391 Email Address: david.klema@gmail.com Phone: 617-461-2395 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: 40 Orono Orchard Rd City: Orono State: MN Zip: 55391 Qtr Section(s): SW Section(s): 35 Township(s): 118N Range(s): 23W Lot: 009 Block: 007 Subdivision: Orono Oaks ND: 3511823340005 4. Size of project parcel (square feet or acres): 2.82 acres Area of disturbance(square feet): 3,000 Volume of excavation/fill (cubic yards):150 Area of existing impervious surface: 1,500 Area of proposed impervious surface: 0 Length of shoreline affected(feet): Waterbody(&bay if applicable): 5. Type of permit being applied for(Check all that apply): IZ EROSION CONTROL 0 WATERBODY CROSSINGS/STRUCTURES ❑ FLOODPLAIN ALTERATION 0 STORMWATER MANAGEMENT ❑ WETLAND PROTECTION 0 APPROPRIATIONS ❑ DREDGING 0 ILLICIT DISCHARGE ❑ SHORELINE/STREAMBANK STABILIZATION 6. Project purpose (Check all that apply): ❑ SINGLE FAMILY HOME 0 MULTI FAMILY RESIDENTIAL(apartments) ❑ ROAD CONSTRUCTION 0 COMMERCIAL or INSTITUTIONAL • ❑ UTILITIES 0 SUBDIVISIONS (include number of lots) ❑ DREDGING CI LANDSCAPING(pools,berms,etc.) ❑ SHORELINE/STREAMBANK STABILIZATION 0 OTHER(DESCRIBE): 7. NPDES/SDS General Stormwater Permit Number(if applicable): 8. Waterbody receiving runoff from site: 9.Project Timeline: Start Date: ASAP Completion Date: 09/15/2016 Permits have been applied for: City 0 County 0 MN Pollution Control Agency 0 DNR 0 COE Permits have been received: City--❑County– 0 MN Pollution Control Agency DNRD COE—0 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 my knowledge and belief,all information is true,complete and accurate. I understand that proceedin:with work before all required authorizations are obtained may be subject to federal,state and/or local ad' ristrative, ivil ay %criminal penalties. 465100/4 rgnature of Each 'roperty Owner D to Ilia ised .i l 13 EROSION CONTROL SUPPLEMENTAL INFORMATION FORM INSPECTION PLAN REQUIREMENTS 1. Routine Inspections: • Once every seven days during active construction • Within 24 hours of a half inch or more precipitation 2. Completed Field Inspection Reports: • Reports available within 24 hours of request until MCWD determines project is complete& stabilized Failure to submit requested inspection information will result in a site inspection and may be subject to reimbursement for MCWD staff time. Who will inspect your site regularly? NAME: David Klema ORGANIZATION: PHONE: 617-461-2395 ALTERNATE PHONE: 203-841-3492 EMAIL: david.klema@gmail.com Where is the concrete washout location? 8 OFF SITE OR CONTAINED ON TRUCK ❑ INDICATED ON SITE PLAN(with required impermeable liner) ❑ N/A What is the final stabilization method? (seed, sod,etc.): Seed, sod 6 inches of topsoil must be added/replaced prior to final stabilization Will protective fencing for retained vegetation be installed? ❑ YES El NOT APPLICABLE ❑ OTHER(describe) I certify that I am familiar with the requirements of the MCWD Erosion Control Rule and that the proposed activity will be conducted in compliance with this rule. David Klema Digitally signed by David Nlema Date:2018.06.1512:02:2805i00 6/15/16 Signature of Applicant or Authorized Agent Date \Jj) WATERSHED MINNEHAHADISTRICCREEK T DUALITY OF WATER,DUALITY OF LIFE 5ri�� it , r1L DATE CO 23"1co No. 770707 RECEIVED FROM DMJtct K I fi .g 1$ ID I i r1 p� '( 0-7) DOLLARS 0OROR RENT 4o Oro r o o rch' a-rd 41). O , 0 fr ACCOUNT O CASH C'►' LC`€a(- 1 I1 V II HECK FROM TO PAYMENT Vv DD rThMONEY ( ORDER `�11 ` 3.ii BAL DUE OCREDIT CARD BY i - -- Ik 2110 DAVID KLEMA 2_,: 20 75.452/912 _ .._ 682 HOLLY AVE#3 - ST.PAUL,MN 55104 . Pay Althe 0 , rof till ,1 646 1 ear Citizens- yr Stets Bank Ill MAIN AVEMIE sane • Rome".1.1 TAWS' r♦�/ • FOR I' x:09 L 2045 271. a 461116391" Lu• 2 L LO , 1 • I