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HomeMy WebLinkAboutExcavating & Filling Permit #11-G-07 � � s f�� ER! �:, !�� __ �� "'�v�.�°.�� "EXHIBIT A" FOR CITY USE ONLY EXCAVATING AND GRADING PERMIT PERMIT # - DATE / f APP�icant: L. �- D�TI�1s o�Z DE.s'i G�v ,�u►d �t�DSifia�t Phone # �/ 2- Zg2' S�lv f Project/Development Name if Applicable: Address: ����. cS g .Sha o�ti L� o� G�j �1'c. i �- P/`i at" G q/fQ Property Owner: TOe d p eb r�► SC �� e S� t � Phone # q.�et "��� 3y6$ Address: �, ��',� ��!//Y GciRfi� 2d - �cfCrl P��'rie .�y.�? _-.--� Contractor: � 04 t/?o ��_�A-OO�Gwa �� Phone # tol�- 7 gl ���L� Address: � $ � Lo� c �r �. - �p //P PL h_ �!'�C T.,,�•/l� .S�l� Consultant Engineer/Surveyor: Phone # Address: Emergency Corrtact (24 hr): ��l�� r ,, 7 ,D��K.�' _ Phone # �Oli l location of Property: Legal Description: Lo -F � j S l,a � i B Pa G G► -� �! n� ZSO�,S � D�O Will the expvation or filling be in a: Watercourse Wetiand Upland � Purpose for the proposed ex ating or filling: � -o � i/7 Estimated start date: ����� Completion date: a'k What is the type of material to be removed or deposited? � What is the quantity of material to be removed or deposited? What is the total area disturbed for excavation or filling? In what manner will the material be removed and/or deposited? What highway, street or other publio-way will material for removal or deposition be hauled or carried? What, if any, street, av nue, lane, alley, hi hwa , right-of-way, thoroughfar or public ground will be obstruded? S'�u��.✓ /3Q'i.Gl� �'�i � Otf� �+IGP /`6f/���L�C nn �i/ IT SHALL BE THE RESPONSIBILITY AND THE BURDEN OF THE APPLICANT TO DEMONSTRATE TO THE SATISFACTfON OF THE CITY ENGINEER FOR THE CITY OF PRIOR LAKE THAT THE PROPOSED EXCAVATION AND/OR FILLING COMPIIES WITH THE OVERALL CITY OF PRIOR IAKE STORM WATER MANAGEMENT PLAN. SAID BURDEN SHALL INCLUDE THE FURNISHING OF A REPORT WITH SUPPORTING CALCULATIONS OF A REGISTERED PROFESSIONAL ENGINEER. Will propased excavation or deposition affect the City of Prior Lake ov rall storm water m�nagement plan? Yes � No If yes, exp{ain proposed effect �!� � be IS�¢i^ h�e /w /t� �('rQ �r,� �l !�r �^� d� SUBMISSION REQUIREMENTS: (A) Complete.cl application form (B) Map or plat of the proposed filling or excavating showing location and amount of material proposed to be removed or deposited, with a description of the area � (C) The depth or heights to which such removal or deposition is proposed throughout the area and the proposed angle of all slopes to be shown on a 2' contour map at a scale of 1"=50' or larger. The proposed and origina( contours shall be 6: Wdmin�PW Dcsign Manua1�2007 PWDM UPDATE�E}CFIIBIT A APPLICATION FOR EXCAV & FIL11NGdoc � � 1 ._. � < � � �! • . . _. . . � , . . . . �, . , ,. � ;.. . . . - . . . - . . , . �� �. � y ; .. . . � . . . , , . , , . ; , : � �. . _ ". ., .. :'.. , . , , � . ° .. . . . - `. . . , � .. . � . , � -, . . . . . . . . . � Y � • . � �. . _ � . .,. . .. „ , . � ...- '� � : ��rxr R� t� � i� „ ' "EXHIBIT A" shown including all property within 200' of proposed excavation or deposition and shall be signed by an engineer or surveyor registered in the State of Minnesota (D) Erosion control plan (E) Affed on existing utilities (F) Application fee (G) Amount of Letter of Credit, or deposit of monies in a sum suffiaer�t to pay the cost of restoring a site. The extra ordinary costs of repairing, highways, streets or other public ways along designated routes of travel and to pay such expenses as the City may incur by reason of doing anything required to be done (N) Public liability insurance CONDITIONS OF APPROVAL: ` � Applicant must call the Engineering Departmerrt for erosion oorrtrol inspection at (952)447-9830 prior to earth moving adivities. (2) Maximum 4:1 slopes are allawed in °maintained' areas except approved by City Engineer. Maximum 3:1 slopes are allowed adjacent natural resources. (3) Slopes greater than or equal to 3:1 shall have approved erosion control Best Management Practices installed immediately after finished grading. (4) Minimum grade for drainage swales shatl be 2°� or greater. (5) Removal or depositing of material greater than 400 cubic yards requires a conditional use permit, unless it is part of a pretiminary plat application. (6) Applicant is responsible for obtaining and meeUng the conditians outlined by other permitting agenaes including but not limited to the following: DNR, Corps of Engineer, Prior Lake/Spring Lake Watershed District, Scbtt CouMy, MW/DOT, MPCA. (7) Applicant is responsible for all damages to other property or facilities as a result of work covered by this permit. (8) Applicant must call the Engineering Department for finaf grading inspection at (952)447-9830 prior to release of grading securiry. (9) Additional Conditions: THE UNDERSIGNED HEREIN CERTIFY THAT THEY HAVE READ SECTION 706 OF THE CITY CODE AND ACCEPT THE TERMS AND CONDITIONS TO THE ISSUANCE OF THIS PERMIT AND AGREE TO FULLY COMPLY THEREWITH TO THE SATISFACTION OF THE CITY F P IOR KE ENGINEERING DEPARTMENT OR ITS DESIGNATED AGENT. Applicant: Date � l� l� �perty Owner: Date � �� �� FOR CIN USE O L . % AUTHORIZATION OF PERMIT Financial Guarantee Amount $ Finanaal Guarantee Type � a•VO (Letter of Credit, Bond, or Cash) Permit Fee $ lDa• o 0 Liability Insurance provided? 0 YesO No (Insurance Certificate must name the City of Prior Lake as an additional insured parly) In consideration of agreement to comply in all respects with the regulations of the City of Prior Lake covering such opera6ons, and pursuant to authorization duly given by said City of Prior Lake, permission is hereby granted for the woric to be done as described in the above application and submitted drawings, said work to be done in acxordance with this application and submitted drawings. ENGINEERING OFFICIAL Date 7� Z� Permit is valid if signed by City Offiaal Permit Eupiration Date �� ��$ I I Planning Dept- Initials s � Gr,�qamin�pW Dayign Manua1�2007 PWDM UPDATE\EXE�TT A APPL[CATION FOR EXCAV 8c FII.LiNG.doc 2 1 � � � NA-026620-03B Minnesota Local/State/Federal A lication Form for Water/Wetiand Pro'ects �� For Internal Use Oniy Applicatian No. Field Office Code Date Initial Application Received Date initial Appiication Deemed Complete "See HELI"' directs you to important additional informafion and �� B�$�C �PPLICATION 1. LANDOR'NERIAPPLI��NT CONTACT INFORMATTON (See Hel � 1) Name: oe Schiesl ��� Phone: 52-944-3468 '� Complete mathng address: 1 r lA. A Only if ppp[icable; an agent is mot requi�ed) Name: had S rks Phone: _�_ Complete mailing addresy; g � p� • N 56011 2• NAME, TYPE AND SIZE OF PUBLIC R'ATERS or WE S IMP A h A itional ro'ect Ar s if Name or I.D. # of Waters Impacted (if applicable; iflmown): • (Check all that apply): QQ Lake ❑ River ❑ Circulaz 39 Wetland tYpe: ❑ l, Q 1L, � 2, (� 3 4, Wetland lant communi I ❑❑ S, � 6, � 7, � g P h' type : Q shallow open water, � deep marsh, [� shallow marsh, � sedge meadow, � fresh meac�w, ❑ wet to wet-mesic prairie, � calcareous fen, [] open bog or coniferous bog, [] shrub-carr/alder thicket, ❑ hardwood swamp or coniferous swamp, � floodplain forest, � seasonally flooded basin Indicate size of entire lake or wetland (check one): ❑ Less thazi 14 acres (indicate size: �� 1 p� 4p � ����. � 40 �es 3. PROJECT LOCATION In rmcrtion can be ound on ro r tax statement, ro r title or title insuranc¢): ProjeCt street address: 14259 Shady Beach Trail ����� � ID #- 250450020 : City (if licable : rior lake . '/, Section: � Section: Township #: Range #: County: cott Lot #: � Block: � Subdivision: Watershe name or # • Attach a simple site locator map. If needed, include on tiie map written directions to the site ownMocat o or lan� k, and provide distances from known locations. Labei the sheet SITE LOCATOR MAP. 4. TYPE OF PROJECT: Describe the of sed work. Attach TypE OF PROJECT sl�et if nceded. horeline boulder repair / renovation S. PROJECT PURPOSE, DESCRIPTION AND DIMENSIONS: Describe what you plan to do and why it is tteeded, how you pian to construct the project with dimensions (length, width, dePth), area of impact, and when you propose to ccrostruct the projeck This !s t6e moat important part of your application. See HEi,p 5 before completing this section; s�ee What To Include on Plans (Instructions, page 1). Attach PROJECT DESCRIPTION sheet Footprint of project: O�res or � sq� f� �ed, filled or excavated. 6. PROJECT ALTERNATIVEg: Wh�t ���� �� p �� s � �j�, �ve you considered that would avoid or minimize impacts to wetlands or waters? List at least TWO additional alternahves to you�. project in Section S that avoid wetiands (oc►e of which may be "uo build" or "do nothing'�, and eacplain why you chose to pursue the option described in this application over tl�se alt6rnatives. Attach PROJECT ALTERNATIYFS sheet if needed, 7. ADdOIMNG PROPERTY OWNERS: For projeccts that imp� more than 10,000 square feet of water or wetlands, list t� complete mailing addresses of adjacent property owners on an attached sepazate sheet. (See AELp � 8. PORTION OF WORK COMPLETED: Is any porhon of the work in wetland ox water areas already compi�t�? � Y� � o � Yes, describe the completed work on a separate sheet of paper labeled WORH ALREADy COMPLETED. (See gEj,p g� � 9. STATUS OF OTHER APPROVALS: List any other permits, reviews or approvals related to this proposed project that are either peudi� or have already been approved or denied on a separate attached sheet. See HELp 9, 10. I am applying for state and loeal authori7atioo to conduct the work described in this application. I am familiar with tl� information � this a'cation To t of my knowledge and belief, atl inforn�ation in part I is irue, compiete, and accurate, i possess the au ori to d e the x des 'bed, or I am acting as th� duly aukhorized agent of the licant. �'� �. ? +� ' �� ��.� ���.� �/ Signo rr� of plicant (LarutoN p� p Signature ofage : applica6le) p� 1'his 1 k mus signed by the person who desires W wxiertake the proposed acrivity and has the r pleas ch a e�rste sF�et si8ned bp the landowr�r, giving n�ess�rY euthorization to the Age�nt. n��Y P aP�Y n$1�s w do so. If onfy the Ag�t has signod, 1 See WeAland Plan(s and Plent Conura�n�es ofMinneaota and Wtsconsln (Eggers and Rex� 199� a� moditied by the Board of water and Soii Raoarcee, United Statea Army Corps of En�neero. Minnesota Locsl/State/Federal Applicatioa Forms for Water/Wetland Anjects Page i APPLICATION FOR DEPARTMENT OF THE ARMy p�+ RMIT 33 CFR 325 OMB APPROVAL NO. 0710-003 Ex ires Dec 31 2004 The public burden for this coilection of informarion is estimated to average 10 hours per response, although the majority of applications should require 5 ho� or less. 17us includes the lime for reviewing inshuctions, seerching existing data sources, gathering and maintaining the data needed, and completing and reviewingthe wilection of infamation. Seud commancs iegarding tlris biuden estrmate or any other aspect of Uus collection of infamation, including suggestions for reducing Uus burden, to Departrnent of Uef�se, Wasiriogton tieadquarters Service Directorate of Informarion pperations and Reports, 12 t5 Jefferson Davis Highway, Suite 1204, Adington, VA 22202-4302; end to the Office of Managemeut and Budget, Paperwork Raduction Project (0710-0003), Washington, DC 2p503. Respondents should be aware that notwithstanding eny other provision oflaw, no person sha41 be subject to any peualty for failing to comply with a collecrion of information if it dces not display a currenUy vatid OMB control number. Please DO NOT RETURN your form to either of these addresses. Completed applicatiaris must be submitted W the Drstrict eogineer having jurisdiction over the locadon of the proposed activiry, PRIVACY ACT STATEMENT: Authoriries: Rivers and Hazbors Act, Secdon 10, 33 USC 403; Clean Water Act, Secdan 404, 33 USC 1344; Marine Protection, Research and Sanctuaries Act, 33 USC 1413, Secaon 103, Principal pwpose: Information provided on Hus form will be used in evaluating the application for a pennit. Routine uses: This information may be shared with the Depaztment of Jusrice and other Federai, state, and local government agencies. Submission of requested informatian is voluntary; however, if infotmation is not rorovide the nermit anvlicarion cannot be evatuated nor can a neimit be issued TTEMS i THROUGH 4 TO BE FILLED IN BY THE CORPS . 1. APPLICATION NO. 2. FIELD OFFICE CODE 3. DATE RECEIVED 4. DATE APPLICATION COMPLET'ED YOU DO NOT NEED TO COMPLETE lTEMS 6-10 and 12-25 in the SHADED AREAS. AU applicants must complete aon-shaded items S and 26. If an agent is used, also complete items 8 and 1 l. This oprional Federal form is valid for use o when included as art of this entire state a}ication ket. 5. APPLICANT'S NAME 8. AUT'HORIZED AGENT'S NAME AND TITLE (an agent is not required) Joe Schiesl ,', 4 � � �� yyy � x�' � � �F ���iTa����a�Sf�' �Fi�� �: . ' .�. � { .: ,y y � � xx � ` j � G ,. Y: 2 F,. : �� , y �. . . ' ��Fl`��i��t �'' �� 1 h 5 i.. 3 � `����� ���x; 3� ��'���+pa�� k i i. STATEMENT OF AUTHORIZA N(jfupplicable; complete onty if authorizing pn agent) v I hereby authorize to acc o behalf as my agent in the processing of ihis application and to furnish, upon request, supplementai information in suppo of thi permit ap i i n. T LICANT"S SIGNATURE: : DATE: " `� , � <, ��'_����'� ; � 5 �'� � � N }. U � � 1�? �4�` �sk���t�t� �E l��l� �t���l51�'� t� �J�`� .`���t',A�S�� �(i�� ��� �� ����►�r �►� ���r ; zs. ��.�:c��'�ti�����r�t�ris, � r�nt�a�rrr�s���u,�� 17, btR�C'�t�13S TQ�,'1��ST� ' t$ L�A�E3� E�� .ttC'tT'C�TTY �. 19,�i4J�C�'�'�E�� 2U R��,�bA�(S�;�S����T�tT�GE �1. `TY�a�`S �F' ��L Bffi�G I�I�CI��� i��`*i� AMQT;�'�' flF ��i 3`�i?E I�i ��TC Y�4•I�?S 2�; 3�:4�L ���A t�t ��t�S t7F W�t"L� f3R U'�1� �I�F1'��tS �JLI.E�7 �3. �� A1'�Y i'C}�.'�'I(7� 0��"�"!3� Vi�t51LT�'. f�LR��i* COM1�L�.�"�? �S., �,': 1�TCJ ,�.�"Y�'s.�;,T)ESC':Iti�l� C�I�fi'I.Fs'L"�t� Wt51�f Z±# �41�1��S5�s^ b�' t��C�IN�"r �{Jl��t�"'Y' £�t�j��+'; �S; .�,IS'�`t)�'�t� �'t'����:11C�NS �R, A�?PI�b�+'AL5f17�iTsh�.�'°I���YL13 ��014� L)�. FID�RAL; ST'A� �'JIt �,t�t4i, rlE`rfi�C� �tJ�t �[7R� i'3��uCfi1�ED Fl� "T�It� �iPP�,ICA't�tjY3; . ;. _ .. , 26. Application is hereby made for a permit or permits to authorize the work described in this appiicarion. I certify that the informarion in this applicat}ari i complete accurate. I further certify that I possess the authority to undertake the work described herein or am acting as the duly suthor�zed ent of ap icant. - ���. �� , '� ��1=� Si tur of appli t D� Si of agent (i Date The p ication mu be sigrnd by the person who desiras to u�ertake the proposed activity (applicsuu r it may be sig�d by a duly authorized agettt if the s ment in Block 11 ties been filted out and signed. 18 U.SC. Scetfon 1061 provides that: Whcever, in any manner within the jurisdiction of azry depsrtment or agency of the United States knowingly and willfully falsifies, conceals, or covers up with azry trick, scheme, or disguisas a raaterial fact or malces any false, fictitious or fraudulent statements or represer►tations or makes or uses nny false writing or document knowing same to contain a�ry false, fictitious or fraudulem statements or entry, shall be fined not more than $l0,OQ0 or imprisoned nat more d�an five years or both. ENG FORM 4345, Ju197 EDITION OF FEB 94 IS OBSOLETE. (Proponern: CECW-OR) Minnesota LocaUState/Federal Applicarion Forms for Wat�er/Weflatxi Ptojects Pago 2 FOR LGU USE ONLY: Determination for Part 1: ❑ No WCA Jurisdiction ❑ Exempt: No. _(per MN Rule 8420.0122) ❑ No Loss: (A,B,. ..G, per MN Rule 8420.0220) ❑ Wetland Boundary or type ❑ Repincement required — appi(carn must wmplete Part II C�MP_L_ETE TI3E SECTION BFi OW O Y TF Fp AC'F��n*T 1�+ NOT RF(ttJ Fi� Appt[catloa is (check one): ❑ Approved �Approved with conditions (conditions attached) ❑ Denied Comments/Findings: LGUo„�cial sfgrratrve � Name mid Title For Agrienitnrai and Drsinage e:emptiona (MI�T Rale 8420.8122 Subps. l and 2B� LG[J 6ss received proof of record[og of restriettoas (per MN Rule 8420A115�: Cowsty where recorded Date Docwnent # asslgned by reco►rder LGU o�cial sigrrature Dp� Minnesota LocallState/Federel Application Forms for Water/Wetiazid Projeets Page 3 . . L � .u,� :MNp .asn � 'w' � w waMr�Y11Y�lrr .r. asr �ir�+���i�. �, .;.�..�._,�w.w, �. �.� � , �� �� '� � . . �� � � ��` � . �. � ,� � ,,,�, . � � �, � �, o ..,,. � � � . , � , c� � � �, � ��. . � ` � '� � . � � � " �� � . , �. ..� �._.�. � � � _ _.�....�..�: _�.,_.._._._._ - � � � �� � � �. � � �� � -� - Page 1 of 1 Chad From: District Technician [districttech(d�plslwd.org] Sent: Thursday, Aprii 14, 2011 4:56 PM To: chad�cioutdoor.com Cc: 'Ross Bintner'; mkinney{�pisNnrd.org SubJect: Landacaping modlfication on an existing lot on Sandy Beach Trail. Chad Sparks — Thank you for the ca11 today inquiring whether your project on an established residential lot on Sandy Beach Traal requires a permit or other approval from PLSLWD. It does not, as fiirther expl�ined below. This determination is in consider�tion of the description you gave me in our conversation, the following excerpts from PLSLWD Rules (at 9.D.), and your intention to obtain any required permits/approvals, such as may be required by the City of Prior Lake. PLSLWD rt�les include these descriptions of activities that do not require a permit: Development or redevelopment of, or construction of a structure on, an individual parcel with a land disturbing activity that does not cause o, f,J`-site erosion, sedimentation, flooding or other damage, and disturbs: (i) In the shoreland protection zone, an area less than 10, 040 square, feet; provided that, zf a municipality or county with jurisdiction has adopted an ordinance requiring stormwater management consistent with this Rule D that also regulates the activity, such ordinance shall govern the activity, and the exempt area shall increase from 10, 000 square feet to one acre (at which po�nt this Rule shald apply in addition to the m�icipal or county regulation); or .... All land dishcrbing activities not required by this Rule to obtain a permit or have an � approved stormwater management plan shall neverthedess be conducted in ficYl compliance with Rule C Thanks for checking with us. Ca11 with any other questions. Jim E�gen, Technicat Consultant to Prior Lake-Spring Lake Watershed District 14070 Commerce Ave NE, Suite 300 - Prior Lake, MN 55372 (952) 378-2167 (office direct) (952) 447-4166 (front desk - office) (612)-501-4826 (cell) (9S2) 447-4167 (fax) 4/19/2011 . .. PERM SIiRV EPA F VAttEY BURVE'YINA t�.. P.A. � ;�,,' . �s��a �� �t� a�. s� � , � q PRlOR LAKE. A�! 55372 I � � � � � (as2) ��-2�m ` 5���� �''� . � ���� � . � �r � � �� .. . l t'�'� ����'� �� �� c��- � � �' � � � �p � lIti47 n - ' . V y� O . �� � •�. ��` �� r efq � �^ c . � � � � �,, -�'"�� , j � «..� � , y T �..�,/ ' �• '�q/ . F � � �� � � .��,. � '-, .� . . a °�' ""'"''' � +u.+ . .� , �. , , � � � �d � t � , � . �� . �� . . plp�� en �sim�i �� ��� �7, ���� ! � • `\ � �� � � : 9467 � 23.f � •�\ , , ,. , 90i.t �� $a:d f� ^ �„ � .,�` � y ., , v, `� �� v � �� 80�•� G . � .!� - � � 0� � � f0!'t ps� �• � • � T pak Y � . � • r �� � y�M.o . . .. � ''� `1 � _�.... ,� . �; � �.. � . � � ; Z � a : �� � � .. .s .. � � ` � '. , ' � qril. �' � 11� + t1..40t0 on M„t g • � � r � � . . � �w�INe 'S:•.. ` t � . ,o... . � R�� � "`— � � - � ' ��'1 • ' ��" ! ' PRfOR LAKE � � ' /�� � � yA` � � a. 9a. s : (J" _ ._.. > _ � ; s, si,,, os > , , i. . ' . � ��V V �� t�WAt. 0�!'110Mt Lpt !� 1MAa'Y KAf�N !pt! Oe�M�i M1a�M0v. 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