EA190249 - NRMP - Stormwater Management Permit - Issued Date 04/25/2024 PERMIT
City of Eagan , a , , Permit Type: "P
3830 Pilot Knob Rd ,��;�� % ,•', Permit Number: EA190249
Eagan, MN 55122 EAGAN
(651)675-5300
waterres@cityofeagan.com * E R 1 9 0 2 4 9
Date Issued: 4/25/2024
Site Address: 1187 Kittiwake Cir
Lot: 49 Block: 1 Addition: Duckwood Estates
PID:10-21900-01-490
Use: * 10 — Z 1900 - 0 1 - 490 *
Comments: Please call Water Resources at(651)675-5300 for inspections.
Before construction begins,an inspection is required to verify that the erosion and sediment control measures shown on
the plan have been installed accordingly.
Fee Summary: Erosion&Sediment Control Deposit $1,300.00 6501.2257
Total: $1,300.00
Contractor: Owner: - Applicant -
Jerzy Szoka
3684 Bridgewater Dr
Eagan MN 55123
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
F For Office Use J J� I
fit I
a a� Stormwater Management Permit#: I
Building Permit#: C I
EAGAN
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I Escrow Deposit: I
3830 PILOT KNOB ROAD i EAGAN,MN 55122-1810 I j
(651)675-5300 i waterresa-cityofeagan.com Staff: I
t-------------------------t
STORMWATER MANAGEMENT PERMIT
Date: 04/04/2024 Site Address: 1187 Kitiwake Cr Eagan Mn. 55123
Description of Project:Remove burn structure, foundation to remain
Area of Land Being Disturbed (acre):0•0 Start Date: 4/14/2024 Completion Date: 4/14/24
Applicant Correspondence Preference(select one):Standard Mail❑or Electronic Mail❑✓
❑ Please submit a Land Disturbance and Stormwater Pollution Prevention Plan with this application.
Name: Jerzy Szoka Phone: 612.227-7457
Address/City/Zip: 3864 Bridgewater Dr
Ptop+ r y wrt r
Contac,: Jerzy Email: 525Excel@gmail.com
Applicant is: Owner ✓ Contractor
Name: Excel Homes Inc Mn. License#: BC763546
Address: 3864 Bridgewater Dr C;ty; Eagan
t ' r '°r
Mn 55123 . 612.227-7457
State: Zip: Phone.
Contact: Jerzy Email: 525Excel@gmail.com
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.) $1,300/lot
New Single-Family Construction $3,900/lot
Multi-Family or Commercial Construction(new,addition,demolition) $6,500/acre*
*Maximum of$15,600
Erosion and Sediment Control Reinspection Fee(for as needed City reinspections after the two(2)included) $115/trip
Security Amount: 11300
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 Jerzy Szoka x, - --2� 4/4124
Applicant's Printed Name Applicat,f' Signature 5�.... Date
xJerzy Szoka x 414124
Owner's Printed Name Owner's Sign re Date
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: Jerzy Szoka
Address/City/Zip: 3864 Bridgewater Dr
Phone: 612.227-7457 Emai1: 525EXCel@gmail.Com
Amount: Permit Number:
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