HomeMy WebLinkAboutSWPPP Verification Form-signedNEW RESIDENTIAL CONSTRUCTION SWPPP VERIFICATION
This form must be completed and submitted with all new residential permit applications.
A National Pollutant Discharge Elimination System (NPDES) Construction Stormwater Permit is
required for “Construction activity that results in land disturbance of equal to or greater than one (1)
acre or if a project is part of a common plan of development that will ultimately disturb greater than
one (1) acre,” (NPDES Permit, Section 1.2).
Project Site Address: _____________________________________________________________________
Company Name: _________________________________________________________________________
*Primary Company Contact: _________________________________________________________________
*Should a site be deemed noncompliant, this individual will be notified
Phone #: ____________________________ Email: ______________________________________________
If you are not covered under a NPDES Construction Stormwater Permit administered by the
Minnesota Pollution Control Agency (MPCA), an erosion and sediment control plan MUST be
approved as part of the residential building permit application.
“Permittees must ensure a trained person will inspect the entire construction site at least once every
seven (7) days during active construction and within 24 hours after a rainfall event greater than ½
inch in 24 hours,” (NPDES Permit, Section 11.2).
The City of Lakeville reserves the right to request weekly inspection logs. The City of Lakeville may
issue a STOP WORK ORDER; withhold building inspections; or, draw on securities/escrows to
bring the site into compliance with the NPDES Construction Stormwater Permit (MN R 100001) or
erosion and sediment control plan.
Contact information of person CERTIFIED to provide weekly onsite erosion and sediment control
inspections and corrective actions:
Name: ____________________________________ Company: ___________________________________
Phone # (24 hr Contact): ______________________ Email: ______________________________________
Entity that Provided Training: __________________________ Certification Expiration Date: ____________
NOTE: Prior to any land-disturbing activity, all erosion and sediment controls must be installed
I understand the above information to be accurate and I have read, understood, and accepted all terms and conditions of the NPDES Permit (MN R 100001).
Signature: ________________________________________________ Date:_________________________
Contact the City of Lakeville with questions at erosion@lakevillemn.gov or 952-985-4500
Brandl Anderson Homes
Mike Swanson
612-363-0002 awheeler@brandlanderson.com
Ryan Lake Lake's Erosion Services, Inc.
612-616-7937 erosion101.RL@gmail.com
University of Minnesota 2021
XXXX 181st Street W (Lot 2, Block 2, Glacier Creek Townhomes
9/2/20 Amanda Wheeler