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4017 Haven Woods Ct - Stormwater PermitEAGAN 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5300 I waterres ac citvofeagan.com For Office Use Stormwater Management Permit #: Building Permit #: ( 7=7 % 3. 6d Escrow Deposit: /1 fa - Staff: STORMWATER MANAGEMENT PERMIT Date: V O A/'Wj.l Site Address: /b (l 11-11--1/M/ kAlf,017S. Description of Project: i\IRAA1 C071/$TY0- 1rG-1-1. ON/ Area of Land Being Disturbed: ` 4 b V b S Start Date: 11-J0/.G-( Completion Date: Ot//8 22- IX Please subrrfira Land Disturbance and Stormwater Pollution Prevention Plan with this application. Property Owner Name: CWtT 6-1 " ti -J '114 Phone: qJt —1- —c 6 14 Address /City /Zip: 66 • 6I E-/V +3 - ba. - - 1 C)1 �'� � Contact: �' GF+- Email: .Q41 Gi/l &i C✓C' VIIn DM h0Y✓�.S /19/i an Applicant is: Owner Contractor Contractor ZSl'Ytfi-S I2-- Name:CiOS ir-1 6Ye_ F7 License #: e&l. 12..1 Address: I 2_ P1 f?[..-1atvq,ir,,."124:r- DP- SE 107-city: ' ai6.Vg.-11 1 tee' ,.�^ —0-5 State: M Al Zip: 4f 25 Phone: q6 — Contact: EA---_ Email: Vic tc-k CefS& 6Y•2 kcyraS m n • C,r;Yr-- Erosion and Sediment Control Performance Security The City requires an escrow deposit to secure performance of erosion and sediment control (ESC) requirements, including proper installation and maintenance. The security shall pay for any City costs or expenses to bring the site into compliance with the stormwater management permit, including any engineering, legal, or administrative expenses; inspections; and necessary work by City contractor(s). The City may extract from the security escrow. The escrow deposit will be released only upon inspection and written notice of conformance by the City. The following escrow deposits include two (2) required City inspections, initial and final. Existing Single -Family Residential Lot (addition, demolition, pool, retaining wall, etc.) $1,000/lot New Single -Family Construction $3,000/lot Multi -Family or Commercial Construction (new, addition, demolition) $5,000/acre* *Maximum of $12,000 Erosion and Sediment Control Reinspection Fee (for as needed City reinspections after the two (2) included) $85/trip $3,000 Security Amount: 25 j�3��/ The applicant assumes all responsibilities for installation and maintenance of pollution prevention practices on this site. Any violations of City Code identified by the City shall be addressed within 48-hours of service of the notification. The applicant understands that failure to maintain pollution prevention practices within the time allotted by the City notification, will result in enforcement action to correct site deficiencies that are in violation of Sec. 4.34. The issuance of this permit constitutes a right -of -entry of the City or its contractors to enter upon the construction site for the purpose of completing ordinance enforcement and/or completing corrective work. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. The undersigned accepts full responsibility for compliance with the Stormwater Management Ordinance of the City of Eagan and agrees to comply with the Stormwater Pollution Prevention Plan or equivalent in full. x Applicanfr's Printe * N : me Applicjant1s Signatur Performance Security Release The following information will determine to whom the escrow deposit will be returned. Security will be returned in the form of a check. Name: Address / City / Zip: Phone: Amount: Email: Permit Number: FOR OFFICE USE ONLY SUB TYPE X Stormwater Management Permit DESCRIPTION Addition X New REQUIRED INSPECTIONS X Initial Inspection X Final Inspection SECURITY Erosion and Sediment Control Deposit (6501.2257) Other: WORK TYPE Apartments Multi Family Single Family Reviewed By: �Brian eyendecker Pool Other: Commercial/Industrial Public Facility $3,000 , Water Resources Date: 11/16/2021