Storm Water Permit Application | Village of Mukwonago

Project Name

Company

Project Type

Erosion Control (Filling of Land Small Projects Determined by Village Engineer)
Storm Water Management Plans

Project Location

Township
Range
Section
1/4

County

Waukesha
Walworth

Please indicate which one you wish to apply for. (Preliminary Review may be required by code.)

Preliminary Review Letter

Items Needed:
1. Signed Permit Application form
2. Certification fo pay review
3. Site Plan Map (Checklist # 1)
4. Preliminary Erosion Control Plan (Checklist #2)
5. Preliminary Storm Water Mgt. Plan (Checklist #3)
6. Preliminary Maintenance Agreement

Storm Water Permit

Items Needed:
1. Signed Permit Application form
2. Certification fo pay review
3. Site Plan Map (Checklist # 1)
4. Final Erosion Control Plan ( Checklist #2)
5. Final Storm Water Mgt. Plan (including construction inspection plan - Checklist # 3)
6. Approved Maintenance Agreement
7. Financial Assurance

The following contacts are required at the time of application.

Applicant: The person or entity holding fee title to the property or their representative, as delegated on page 2 of this form. The applicant shall sign the initial permit application form in accordance with the items 1-5 listed below, after which the applicant may provide written authorization for others to serve as the applicant's representative: 1) In the case of a corporation, by a principal executive officer of at least the level of vice-president or by the officer's authorized representative having overall responsibility for the operation of the site for which a permit is sought; 2) In the case of a limited liability company, by a member or manager; 3) In the case of a partnership, by the general partner; 4) In the case of a sole proprietorship, by the proprietor, or; S) For a unit of government, by a principal executive officer, ranking elected official or other duly authorized representative.
Engineer ( or Planner): The primary contact for the preparation of erosion control and storm water management plans. All plan review comments will be addressed to this contact. For all storm water plans and other engineering, this person must: 1) be a licensed P.E. in Wisconsin; 2) stamp P.E. number and sign all plans submitted as part of permit; and 3) oversee and verify construction of all practices.

Contact Information

Additional contacts are required before a permit will be issued.

Contact #1

First Last

Is this person authorized as an applicant representative?

Yes
No

Company

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Please indicate responsibilities assigned to this contact. (check all that apply)

Contact #2

First Last

Is this person authorized as an applicant representative?

Yes
No

Company

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Please indicate responsibilities assigned to this contact. (check all that apply)

Erosion Control Inspector Contact Information

Name

First Last

Company

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Please indicate how the inspection log will be made available to the Waukesha County.