2003-10-07 2 MPCA Permits, 1 SWPPP
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TRANSMITTAL
1200 25th Avenue South, POBox 1717, St Cloud, MN 56302 1717
320 229 4300
800572 0617
320 229 4301 FAX
TO Lmda Goeb
CIty of AlbertvIlle
October 7, 2003
Date
A-ALBEV 0401 D64
FIle Number and LocatIon
Ghent Number
RE ,l.L I Alhertvtllas Park, Albertvtlle, MN
We are
181 Enclosmg
o Sendmg Under Separate Cover
o As Requested
Please sign Article 15 and return one copy to me ASAP.
2 MPCA NPDES penrut
For your files.
1 Storm Water PollutIon PreventIOn Plan (SWPPP)
For your
o InformatIOn/Records
181 Action
REMARKS
o ReView
o DlstnbutlOn
181 Approval
o RevIsion and resubmlttal
SIgn ArtIcle 15 and return one copy to me ASAP Keep the second copy for your flies
BY DebbIe Gllyard
c
dJg
u lalalbev\common\d64 2003 a1bertvllla, park\t cIty npde, 10070, doc
10/01
Short Elliott Hendrickson Inc
Your Trusted Resource
Equal Opportunity Employer
'flus form IS for new permIt applIcatIons only
Extstmg pernnttees must use Application for Pemut Transfer/Modificatlon to transfer a pernnt to one party or SubdIvIsIOn RegIstratIOn for mulllple parlles
MPCA use only
NatIonal Pollutant DIscharge ElnmnatIon System (NPDES)/State DISpOSal System (SDS)
Application for General Storm-water Permit
for Construction Activity (MN R1 00001)
~~~
Minnesota
Pollution
Control
Agency
Minnesota Pollution Control Agency
REM DIvIsion, Construction Storm-water Permit Program
520 Lafayette Road North, St Paul, MN 55155-4194
I
I
ID# I
Check # I
Please refer to the apphcation InstructIons and the NPDES/SDS General Storm-water Pernot for ConstructIon ActiVity
(MN RIOOOOl) as yon complete this form See brackets [ ] for speCific pernot references.
Call the MPCA Customer AsSIstance Center at 651-297-2274 or 800-646-6247 (m Mmn) for assIstance
1 Storm-water Pollution Prevention Plan (SWPPP)
a Has a Storm-water PollutIon PreventIOn Plan been developed for thIS project and
mcorporated mto the project's plans and specIficatIOns? [part III A]
b Are erOSIon preventIOn measures addressed m the SWPPP? [Part IV B]
c Are sedIment control measures addressed m the SWPPP? [part IV C]
dAre dewatenng and basm drammg addressed m the SWPPP? [Part IV D]
e Are mspectIons and mamtenance addressed m the SWPPP? [part IV E]
f Are pollutIOn preventIOn management measures addressed m the SWPPP? [part IV F]
g Is fmal stabIlIzatIOn addressed m the SWPPP? [part IV G]
h If an enVIronmental reVIew was reqUIred, dId you mcorporate all storm-water related
lllitIgatIOn measures contamed m the reVIew mto the SWPPP?
STOP If you responded no to any quesnon above A SWPPP must be developed pnor to subrmtbng a penmt applicatIOn
Complete the above reqUirements and check yes before submitting thiS applicallon ContlDue If you responded yes or na
to all uesllons above
A-ALBEV 0401 D64
[gIYes DNo
[gIYes DNo
[gIYes DNo
[gIYes DNo
[gIYes DNo
[gIYes DNo
[gIYes DNo
[gINA DYes DNo
2. Discharges to Special Waters
Mark NA If no dIscharges descnbed below WIll occur
a Are all storm-water dIscharges that may flow from the project to a SpeCIal Water that IS [gINA DYes DNo
located wIthm 2,000 feet of any project dIscharge pomts addressed m the SWPPP to meet
the emut condItIOns m A endIx A, Part A-C?
STOP If you responded no Complete the above reqUirements and check yes before submltbng this applicatIon ContlDue
If ou res onded es
3. AddItional ApphcatIon Review
a WIll the project mclude alternatIve treatment methods? [part III C 5]
If yes this applicanon and the a1temallve treatInent plans must be subrmtted a rmIDmum of 90 days before constructIon starts
b If yes, are the plans attached?
c WIll the project dIsturb 50 acres? AND Is there a dIscharge pomt wIthm 2000 feet of an ImpaIred or
speCIal water whose dIscharge may reach an ImpaIred or speCIal water lIsted m AppendIX A of the
pemut? [part n BIb]
If yes this applicanon and the SWPPP must be subrmtted a ffilIDmum of 30 days before construcnon starts
d If yes, IS the SWPPP attached?
4 ApplIcation Fee
Is the reqUIred $400 ApplIcatIOn Fee enclosed?
wq-strm2-57
100
DYes [gINo
DYes DNo
DYes [gINo
DYes DNo
[gIYes
August 2003
2003 AlbertvIllas Park
5 Project Name
6. Dates of ConstructIon 10
/06
/03
10
/30
/03
a ConstructIon Start Date
b Esllmated CompletIon Date
7. Project Location
At the mtersectlon of KaIser and Kah Avenue
Site Address Actual location
AlbertvIlle
Indicate general location descnptlon ifno address IS available Do not use a POBox
AlbertvIlle
City or Township
AlbertvIlle
MN 55301-0009
State Zip Code
All cItIes where constructIon Will occur
Wnght
All countIes where construcllon Will occur
8. County Parcel ID #
10 Project Map
11. Project Type
12. CumulatIve
ImperVIOus
Surface
13. Permanent
Storm-water
Management
14 ReceIVIng
Waters
Name of Water Body
All townships where construcllon will occur
9. Project Size
53
Number of acres to be disturbed
Attach hst If necessary
Is the reqUIred 8 Y2 x 11" Umted States GeologIcal Survey (USGS) 7 5 mmute quad or Dyes
eqUIvalent map mdIcatmg SIte boundanes attached?
o ReSIdentIal
DCommercIallIndustnal
D Road ConstructIOn
123 Other
School
a
EXIstmg area of ImpervIOUS surface
o
(to the nearest quarter acre)
b
Post constructIon area of ImpervIOUS surface 56 (to the nearest quarter acre)
If new ImperVIOUS surface created by the project IS less than one acre, skip to questIon 14.
What types (check all that apply) of permanent storm-water management WIll be used If more than one
acre of new ImpervIOUS surface IS created by the project? [Part ill C]
123 Wet SedImentatIOn Basm 0 InfIltratIOn/FtltratIOn D RegIOnal Pondmg
o AlternatIve Methods (/fusmg alternative methods, constructIOn cannot commence until receiving approvalfrom the MPCA)
IdentIfy surface waters wIthm Y2 mIle of project boundary that wtll receIve storm water from the SIte or
dIscharge from permanent storm-water management system Include waters shown on USGS 7 5 ffilnute
uad or UIvalent and all waters IdentIfied m A endIx A of the efffilt Add addItIonal a er If needed
AppendIX A
Type (ditch pond wetland, lake, stream, nver) S eClal water?
Swamp Lake
Adjacent sedImentatIon basm
wq-stnn2-57
Pond DYes ~No
Lake DYes ~No
DYes DNo
DYes DNo
DYes DNo
20f3 August 2003
15. Owner
CIty of AlbertvIlle
41-1252624
9766764
BUSIness or Ftrm Name
Federal Tax ID
State Tax ID
763 497 3384
Goeb
Lmda
CIty Adrmmstrator
TItle
E-mall
AlbertvIlle
Telephone (mclude area code)
MN 55301-0009
Last Name Ftrst Name
5975 Mam Avenue NE, PO Box 9
Mallmg Address
MIddendorf
Cuy
State ZIp Code
763 497 3384
John
Alternate Contact Last Name
Ftrst Name
E-mall
Telephone (mclude area code)
I Certlfy under penalty of law that thiS document and all attachments were prepared under my direction or supervision m accordance With a system
deSigned to assure that qualIfied personnel properly gather and evaluate the mformatIon subrmtted Based on my mqUlry of the person or persons
who manage thiS system, or the persons directly responSible for gathenng the mformatIon, the mformatIon IS, to the best of my knowledge and belIef,
true, accurate and complete I am aware that there are signIficant penalties for subrmttmg false mformatIon, mcludmg the possibilIty of fine and
Impnsonment for knowmg VIOlations
I also certIfy under penalty oflaw that I have read, understood, and accepted all terms and conditions ofthe NPDES/SDS General Storm-water
Perrmt ConstructIOn ActiVity (MN RlOOOOI) that authonzes storm-water discharges associated with the constructIOn site Identified on thiS form
()~/O-()3
gnature Date
catIOn must be signed by
· Corporatwn a pnnclpal executive officer of at least the level of vice-president or the duly authonzed representative or agent of the executive officer if the
representative or agent IS responsible for the overall operation of the facllzty that IS the subject of the pemut application
. Partnership or Sole Propnetorshlp a general partner or the propnetor
· MunICipality, State, Federal or Other PublIC Agency pnnclpal executive officer or rankmg elected official
16. Contractor
Busmess or Firm Name
Federal Tax ID
State Tax ID
Last Name
Fust Name
TItle
E-mall
Telephone (mclude area code)
Mlllhng Address
CIty
State
ZIp Code
Alternate Contact Last Narne
Fust Name
E-mllll
Telephone (mclude area code)
I certIfy under penalty of law that thiS document and all attachments were prepared under my dIrection or supervlSlon m accordance With a system
deSigned to assure that qualified personnel properly gather and evaluate the mformatlOn subrmtted Based on my mqUlry of the person or persons
who manage thiS system, or the persons dIrectly responSible for gathenng the mformatIon, the mformatIon IS, to the best of my knowledge and belIef,
true, accurate and complete I am aware that there are significant penalties for subrmttmg false mformatIon, mcludmg the possibilIty of fine and
Impnsonment for knowmg VIOlations
I also certify under penalty of law that I have read, understood, and accepted all terms and conditions of the NPDES/SDS General Storm-water
Perrmt for ConstructIOn ActiVity (MN RlOOOOl) that authonzes storm-water discharges associated With the construction site Identified on thiS form
Autltonzed SIgnature Date
This ApplicatIOn must be Signed by
· Corporation a pnnczpal executive officer of at least the level of vice-pres went or the duly authonzed representative or agent of the executive officer if the
representative or agent IS responSible for the overall operation of the faCility that IS the subject of the pemut application
· Partnershtp or Sole Propnetorshlp a general partner or the propnetor
· MunICtpallty, State, Federal or Other PublIC Agency pnnczpal executive officer or rankmg elected offiCial
wq-stnn2-57
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August 2003
STORM WATER POLLUTION PREVENTION PLAN (SWPPP)
NPDES General Stormwater Permit for
Construction Activity No. MN Rl0000l
October 7, 2003
Project
2003 AlbertvIllas Park
AlbertVIlle, MN
SEH No A-ALBEV 0401 D64
Owner
CIty of AlbertVIlle
5975 Mam Avenue NE
PO Box 9
AlbertvIlle, MN 55301-0009
Contact John MIddendorf (Water and Sewer)
SWPPP SUMMARY/OVERVIEW
ThIS Storm Water PollutIOn Prevention Plan (SWPPP) has been developed by the CIty to address
the reqUIrements of NPDES PermIt MN RlOOOOl, Part ill, Subpart A ThIS SWPPP mcludes a
combmatIon of narrative and attached fIgure(s) and plan sheets that descnbe the temporary and
permanent and storm water management plan for the project The numbered sectIOns below
correspond to the same sections of the NPDES PermIt
Part III.A. Storm Water Pollution Prevention Plan
Nature of construction activity:
The project WIll conSIst of gradmg and turf restoration for a future baseball fIeld and soccer fIeld
Soil disturbing activities:
Removal of unSUItable vegetation, gradmg, and preparatIOn for fmal restoration
1. Person knowledgeable in erosIOn prevention and sediment control and who will
oversee implementatIOn of the SWPPP:
John MIddendorf, Water and Sewer
ResponSIble for long-term operation and maintenance:
John MIddendorf, Water and Sewer
2. Narrative descnbmg timing of installation of BMPs in Parts III, IV, Appendix A:
No construction WIll begm pnor to the approval of the eroSIOn control plan by the City
Areas where constructIOn actiVIty temporanly stops for more than 21 days wIll be
stabIlIzed WIth a temporary seed and mulch wIthm 21 days of the halt of constructIOn
NPDES PermIt MN R 100001, SWPPP
AlbertVIlle Pnmary School Ball FIeld
10/07/03
Page 1 of 5
Once constructIOn IS completed m an area, that area WIll be stabIlIzed wIth seed and
mulch
3. SWPPP Requirements:
a. Erosion Prevention and Sediment Control BMPs
Temporary
Storm sewer mlets WIll be protected usmg MnlDOT Type C mlet protectIOn
(SpeCIficatIon 3891) SIlt fence WIll be mstalled around the penmeter of the project
See attached plan sheets
Permanent
DIsturbed portIons of the sIte WIll be seeded wIth MnlDOT seed lTIlxture 270 RT
applIed at a rate of 120 Ibs/ac Type 3 mulch WIll be applIed at a rate of 2 tons/ac and
24-12-24 fertIlIzer WIll be applIed at a rate of 300 Ibs/ac DISC anchonng WIll be
completed to enhance fmal SOlI stabIlIzatIOn DIsturbed portIons of the sIte where
constructIOn actIVIty has been permanently stopped shall be stabIlIzed WIth seed
wlthm 14 days of the last constructIon actIVIty
See attached plan sheets
b. Site map WIth eXlstmg and final grades:
See attached plan sheets
c. Locations of areas not to be disturbed:
NA
d. Locations where construction will be phased to mmimized exposed soil areas:
NA
e. Surface waters and wetlands within 1/2 mIle that will receIve storm water:
NA
f. Methods for final stabIlizatIon of exposed sods:
DIsturbed portIons of the SIte WIll be seeded WIth MnlDOT seed mIxture 270 RT
applIed at a rate of 120 Ibs/ac Type 3 mulch WIll be applIed at a rate of 2 tons/ac and
24-12-24 fertIlIzer WIll be applIed at a rate of 300 Ibs/ac DISC anchonng WIll be
completed to enhance final soIl stabIlIzatIon DIsturbed portIOns of the SIte where
NPDES PermIt MN R 100001, SWPPP
AlbertVIlle Pnmary School Ball FIeld
10/07/03
Page 2 of 5
construction activIty has been permanently stopped shall be stabIlIzed wIth seed
wIthm 14 days of the last construction activIty
4. Amendments to the SWPPP:
The SWPPP WIll be amended as needed and/or as reqUIred by prOVISIOns of the
PermIt
5. Mitigation measures required from previous reviews (EA W, EIS, local, etc):
NA
6. Karst and drinking water supply management area measures:
NA
7. Discharges to waters with an APPROVED TMDL:
NA
Part III.C. Temporary Sediment Basins
Where ten acres of dIsturbed soIl dram to a common locatIOn, a temporary sedIment basm IS
reqUIred The proposed project IS dIsturbmg less than ten acres
Part III.C. Permanent Storm Water Management System
Where the project has replaced vegetatIon and/or other pervIOUS surfaces wIth one or more acres
of cumulative ImpervIOUS surface, a water qualIty volume of ~ mch of runoff from the new
ImpervIOUS surfaces created by the project must be treated by one of the methods outlIned m Part
III C 1 through Part III C 5 (Wet SedImentatIOn Basm, InflltratIonIFIltratIOn, RegIOnal Ponds,
CombmatIon of Practices, Alternative Method) pnor to the runoff leavmg the SIte or entenng
surface waters
For those areas where there IS no practicable way to meet the treatment reqUIrement for the water
qUalIty volume, other treatment such as grassed swales, smaller ponds or gnt chambers IS
reqUIred pnor to dIscharge to surface waters A cumulative maXImum of three acres or 1 % of
project SIze whIchever IS larger may be treated m thIS manner
Storm water dramage WIll be conveyed by curb and gutter and storm sewer to the eXIstmg
sedImentation basm
Part IV. Construction Activity ReqUIrements
A. Storm Water Pollution Prevention Plan
NPDES Perrmt MN R 100001, SWPPP
AlbertvIlle Pnmary School Ball FIeld
10/07/03
Page 3 of 5
The SWPPP and BMPs IdentIfied wIll be Installed and Implemented In an appropnate and
functIonal manner
B. Erosion PreventIOn Practices
See Part ill A 3 a for erosIOn preventIon and sedIment control BMPs
C. Sediment Control Practices
See Part III A 3 a for erOSIon preventIon and sedIment control BMPs
D. Dewatering and Basin Draining
NA
E. Inspections and Maintenance
The constructIOn sIte WIll be observed once every 7 days dunng actIve constructIOn and wIthIn
24 hours after a raInfall event greater than 0 5 Inches In 24 hours
When sedIment IS observed up to approxImately one-thIrd of the heIght of sIlt fence, sedIment
WIll be removed SIlt fence WIll be repaIred, replaced, or supplemented If It becomes
nonfunctIOnal
A summary maIntenance/constructIOn observatIon report WIll be recorded after each SIte
VISIt/observatIOn
Permanent seedIng WIll be observed for growth and washouts
InspectIOn and maIntenance reqUIrements shall be completed as outlIned m the NPDES Phase II
ConstructIOn PermIt
F. Pollution Prevention Management Measures
The dISpOSal and/or storage of hazardous waste and matenals WIll comply WIth MPCA
regulatIons
G. Final StabilIzation
See Part ill A 3 a for permanent erOSIOn and sedIment control
The permIttee wIll submIt a NotIce of TermmatIOn (NOT) WIthIn 30 days after fmal stabIlIzatIon
IS complete
Appendix A.
NPDES PermIt MN R 100001, SWPPP
AlbertvIlle Pnmary School Ball FIeld
10/07/03
Page 4 of 5
'"
A. General Requirements
All reqUIrements III thIS AppendIX are III addItIon to BMPs already specIfIed The provIsIons III
thIS AppendIx take precedence
B. Requirements for Discharge to Special Water
NA
c. Additional BMPs for Special Waters
NA
D. Requirements for Discharging to Wetlands
NA
E. Discharges Requiring Environmental Review
NA
F. Discharges Affecting Endangered or Threatened Species
NA
G. Discharges Affectmg Historic Places or Archeological Sites
NA
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NPDES PermIt MN R 100001, SWPPP
AlbertvIlle Pnmary School Ball FIeld
10/07/03
Page 5 of 5