HomeMy WebLinkAbout2018-05-09 BCWD Permit Application With City Signature44 455 FlAYWARD AVE NB ROWN S,���..►
iI 0AKD�ALE, MN
E E K.'�651,330.7747 1 FAX
DISTRICT�:
PERMIT APPLICATION
Pr*ct Information To Be Completed By The Applicant
Date 5/8/2018
Name of Project: Oak Park Heights- Holiday Inn Ex ress & Suites
Purpose of Project: Development of new hotel
Location of Project (street address, if (mown): Memorial Avenue N.
City or Township: Oak Park Heights
Legal description: Section: 1/4 Section: Township: N. Range: W
General Project Description: Development of new hotel- see Stormwater Report for more information
Authorized Agent (Engineer): Eric D. Kaul and James R. Skowronski
Representing (Applicant): Madison Hospitality
Street Address: Madison Hospitality
City. Sauk City, WI Zip: 53583 Email: ekaul@rama r:com
Day Telephone: _608.643.41 00 Fax: � �Q
ignature of thorized Agent)
Applicant (if not yet Property Owner): Kirk Schultz
Representing: Madison Hospitality Group, LLC
Street Address: 1914 S. 7th Street
City: Brainerd Zip: 56401 Email: kirk@mhgmn.com
Day Telephone: 612.325.7652
Fax: 320.468.2049
(Signatur Applicant)
Property Owner: City of Oak Park Heights Eric
Owner's Street Address: 14168 Oak Park Blvd. N
Owner's City: Oak Park Heights
Telephone: 651.439.4439 Fax: 651. 9.05
OWNERS SIGNATURE (REQUIRED):
Owner's Zip: 55082
Managers: Craig Leiser, President • Connie Taillon, Treasurer ' Ger#d Johnson, Secretary • Gail Pundsack, Vice -President ' Sharon Schwarze
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PERMIT APPLICATION
Permit Application for Approval of:
(check all that apply)
Rule 2.0 Stormwater Management:
(_ ) Rule 2.2a - Land Development -Subdivision of 4 lots
$2,000
U Greater than 4 lots
$100/additional lot
RuIe 2.2b -f — All other stormwater rule applications
$3,000
39G, em"
Rule 3.0 Erosion Control:
�} Activities/Grading less than 1 acre
$1,000
1a�1/ 1.0 - 4.99 acres
$1,250
v
U 5.0 - 19.9 acres
$1,500
(� 20 or more acre
$2,000
(� Rule 5.0 Shoreland and Streambank Alterations 0
$1,500
�} Rule 6.0 Stream and Lake Crossings
$1,500
U Rule 7.0 Floodplain and Drainage Alterations
$500
TOTAL FEE DEPOSIT 4a? S0, e
APPLICATIONFEE ESCROW WILL BE CUMULATIVE FOR EACH APPLICABLE CATEGORY. When a project is approved by the
BCWD Board, the permit fee deposit must be replenished to the deposit amount by the applicant before the permit will be issued to cover
actual costs incurred to monitor compliance and address non-compliance with the BCWD Rules. ANY COSTS INCURRED BY THE BCWD
GREATER THAN THE PERMIT FEE DEPOSIT BALANCE WILL BE BILLED TO THE APPLICANT. Any unused portion of the
deposit balance will be returned to the applicant when the Board determines that the work has been completed under the permit.
rerrormantce Sure Deposit
Additional Project Information (required)
The BCWD Board will determine a performance surety amount in addition to the Permit Fee Deposit. The amount of the surety
will be based on the following criteria. The BCWD Board may consider payments made in lieu of site specific mitigation.
Total Area of Disturbed Land Surface as a Result of This Project (acres) «, 3 /}Co f -
Estimated Construction Cost of Stormwater Managment Facilities (incudes ponds, pipes, etc.) $ C0A T-e_Af, s T& D
U.au kooi) Is11-6ZAU ext cu it assistance in completing this form is required. Please attach drawings, plans and other data as outlined in 'Brown's Creek
Watershed District, Permit Application Materials," available upon request Mail or deliver this form along with the appropriate Permit Fee Deposit and
the appropriate type and number of exhibits to the above address. Applying for this permit from BCVM does not preclude your applying for any
necessary permits that may be required from other governmental agencies.
Managers: Craig Leiser, President ' Connie Taillon, Treasurer ' Gerald Johnson, Secretary ' Gait Pundsack, Vice -President ' Sharon Schwarze
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