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 �'�
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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