Form Center

2. City of Whitewater

   312 W. Whitewater Street
   P.O. Box 178
   Whitewater, WI 53190
   262-473-0540
   www.whitewater-wi.gov

3. Stormwater Management Permit Applicaiton
6. Instructions:

   Read all instructions before completing applciation.

8. Name of Project*
10. Applicant/Entity Receiving Permit
12. Name of Applicant*
14. First Name of Contact*
15. Last Name of Contact*
17. Address*
19. City*
20. State*
21. Zip Code*
23. Phone Number*
24. Fax Number
26. Email Address*
28. Property Owner
30. First Name*
31. Last Name*
33. Address*
35. City*
36. State*
37. Zip Code*
39. Phone Number*
40. Fax Number
42. Email Address
44. Parcel Identification Number(s)
46. Engineer
48. Name of Firm
50. First Name of Contact
51. Last Name of Contact
53. Address
55. City
56. State
57. Zip Code
59. Phone Number
60. Fax Number
62. Email Address
66. City of Whitewater

    Stormwater Management Plan Application Checklist

68. Project Name
69. Permit Number
71. Date
73. Please check the appropriate box I=Included: NA=Non-Applicable
74. (If "NA" is checked, an explanation must be entered.)
76. Checklist
78. A. Submittal Requirements
80. 1. Permit Application Form
81. I or NA*
    -- Select One --INA
82. Explanation/Location in Plan
84. 2. Maintenance Agreement
85. I or NA*
    -- Select One --INA
86. Explanation/Location in Plan
88. 3. Financial Guarantee
89. I or NA*
    -- Select One --INA
90. Explanation/Location in Plan
92. 4. Certification/Stamp of Wisconsin Prof. Engineer
93. I or NA*
    -- Select One --INA
94. Explanation/Location in Plan
96. B. Predevelopment Site Conditions Mapping
98. 1. Location Map
99. I or NA*
    -- Select One --INA
100. Explanation/Location in Plan
102. 2. Soils Survey Map
103. I or NA*
     -- Select One --INA
104. Explanation/Location in Plan
106. 3. Existing Land Use Mapping
107. I or NA*
     -- Select One --INA
108. Explanation/Location in Plan
110. 4. Predeveloped site Conditions
111. I or NA*
     -- Select One --INA
112. Explanation/Location in Plan
114. a. Existing Contours
115. I or NA
     -- Select One --INA
116. Explanation/Location in Plan
118. b. Property Lines
119. I or NA*
     -- Select One --INA
120. Explanation/Location in Plan
122. c. Existing flow paths and direction
123. I or NA*
     -- Select One --INA
124. Explanation/Location in Plan
126. d. Outlet locations
127. I or NA*
     -- Select One --INA
128. Explanation/Location in Plan
130. e. Drainage basin divides and subdivides
131. I or NA*
     -- Select One --INA
132. Explanation/Location in Plan
134. f. Existing drainage structures on and adjacent to the site.
135. I or NA*
     -- Select One --INA
136. Explanation/Location in Plan
138. g. Nearby Watercourses
139. I or NA*
     -- Select One --INA
140. Explanation/Location in Plan
142. h. Lakes, streams, wetlands, channels, ditches, etc.
143. I or NA*
     -- Select One --INA
144. Explanation/Location in Plan
146. i. Limits of the 100-year floodplain
147. I or NA*
     -- Select One --I NA
148. Explanation/Location in Plan
150. j. Wells/Wellhead Protection Areas
151. I or NA*
     -- Select One --INA
152. Explanation/Location in Plan
154. C. Post-Development Site Condition Mapping
156. 1. Pervious Surfaces
157. I or NA*
     -- Select One --INA
158. Explanation/Location in Plan
160. 2. Impervious Surfaces
161. I or NA*
     -- Select One --INA
162. Explanation/Location in Plan
164. 3. One Foot Topographic Contours
165. I or NA*
     -- Select One --INA
166. Explanation/Location in Plan
168. 4. Proposed Drainage System (including applicable off-site)
169. I or NA*
     -- Select One --INA
170. Explanation/Location in Plan
172. 5. Proposed Easement Locations
173. I or NA*
     -- Select One --INA
174. Explanation/Location in Plan
176. 6. Proposed Flow Paths Overland Flow Routes
177. I or NA*
     -- Select One --INA
178. Explanation/Location in Plan
180. 7. Proposed Outlets/Drainage Divides
181. I or NA*
     -- Select One --INA
182. Explanation/Location in Plan
184. D. Drawings/Details
186. 1. Practice Location/Layout/Cross Sections
187. I or NA*
     -- Select One --INA
188. Explanation/Location in Plan
190. 2. Outlet Structure Details
191. I or NA*
     -- Select One --INA
192. Explanation/Location in Plan
194. 3. Ditch/Storm Sewer Plan/Profile
195. I or NA*
     -- Select One --INA
196. Explanation/Location in Plan
198. 4. Other
199. I or NA*
     -- Select One --INA
200. Explanation/Location in Plan
202. E. Calculations, including computer modeling input and output fiiles
204. 1. Hydrograph Parameter Calculations
205. I or NA*
     -- Select One --INA
206. Explanation/Location in Plan
208. 2. Computer Modeling Input/Output (Pre and Post-Development
209. I or NA*
     -- Select One --INA
210. Explanation/Location in Plan
212. 3. Detention Pond Routing
213. I or NA*
     -- Select One --INA
214. Explanation/Location in Plan
216. 4. Conveyance System Design
217. I or NA*
     -- Select One --INA
218. Explanation/Location in Plan
220. 5. Other
221. I or NA*
     -- Select One --INA
222. Explanation/Location in Plan
224. F. Narrative
226. 1. Methodologies and Assumptions
227. I or NA*
     -- Select One --INA
228. Explanation/Location in Plan
230. 2. Results/Conclusions
232. a. Pre and Post-developed parameter summary
233. I or NA*
     -- Select One --INA
234. Explanation/Location in Plan
236. b. Pre and Post-developed peak discharge summary
237. I or NA*
     -- Select One --INA
238. Explanation/Location in Plan
240. 3. Provisions to preserve nature topography/cover features
241. I or NA*
     -- Select One --INA
242. Explanation/Location in Plan
244. 4. Limitations from wellhead protections plans and ordinances
245. I or NA*
     -- Select One --INA
246. Explanation/Location in Plan
248. 5. Results of investigations of soils and groundwater
249. I or NA*
     -- Select One --INA
250. Explanation/Location in Plan
252. 6. Practice Installation Schedule
253. I or NA*
     -- Select One --INA
254. Explanation/Location in Plan
256. 7. Maintenance Plan
257. I or NA*
     -- Select One --INA
258. Explanation/Location in Plan
260. 8. Cost Estimates
261. I or NA*
     -- Select One --INA
262. Explanation/Location in Plan
264. Other Information
265. I or NA*
     -- Select One --INA
266. Explanation/Location in Plan
268. Document Upload
269. Document Upload
270. Document Upload
272. Document Upload
273. Document Upload
274. Document Upload
278. Application Checklist Summary Tables Examples

     Please use below examples to model summary tables and upload tables below.

280. Hydrologic Parameters

     Basin Name	Drainage Area (Ac) Existing	Drainage Area (Ac) Proposed	Runoff Curve Number Existing	Runoff Curve Number Future	Time of Concentration (min) Existing	Time of Concentration (min) Future

282. Peak Discharge Summary

     Outfall No.   
     Peak Discharge (cfs)

     Storm Frequency	Predev.	Postdev.	Postdev. w/Detention
     2-Year
     5-Year
     10-Year
     25-Year
     50-Year
     100-Year

      Note:  Provide 1 table for each outfall locaton.

     
     

284. Detention Basin Summary

     Detention Basin: 

                                                      Peak Discharge (cfs)

     Storm Frequency	Storage Volume (ac-ft)	Inflow	Discharge	Pond Elevation
     2-Year
     5-Year
     10-Year
     25-Year
     50-Year
     100-Year

     Note: Provide 1 table for each detention basin.

286. Upload Hydrologic Parameters
287. Upload Peak Discharge Summary
288. Upload Detention Basin Summary
292. City of Whitewater
294. Stormwater Management
295. Permit Number
297. Date of Application*
299. Site Address*
301. Plat Name
303. Certified Survey Map
305. Lots No. (s)
307. General Conditions

     (a)  All storm water management measures shall be installed in accordance with the approved storm water management plan and this permit.

     (b)  The Director of Public Works shall be notified at least three (3) business days before commencing any work in conjunction with the storm water management plan, and within three (3) business days upon completion of the storm water management practices.

     (c)  Practice installations shall be certified "as built" by a licensed professional engineer.  Completed storm water management practices must pass a final inspection by the Director of Public Works or its designee to determine if they are in accordance with the approved storm water management plan and ordinance.

     (d)  The Director of Public Works shall be notified of any significant proposed modifications to an approved storm water management plan.

     (e) All storm water management practices shall be maintained in accordance with the storm water management plan until the practices either become the responsibility of the City of Whitewater, or transferred to subsequent private owners as specified in the approved maintenance agreement.

     (f)  The City of Whitewater is authorized to perform any work or operations necessary to bring storm water management measures into conformance with the approved storm water management plan, and consent to a special assessment or charge against the property as authorized under subch. VII of ch. 66, Wis. Stats. , or to charging such costs against the financial guarantee posted under S. 10.

     (g)  If so directed by the Director of Public Works, all damage to adjoining facilities and drainage ways caused by runoff, where such damage is caused by activities that are not in compliance with the approved storm water management plan shall be repaired at the permitee's expense.

     (h)  Access is permitted to the Director of Public Works or its designee for the purpose of inspecting the property for compliance with the approved storm water management plan and this permit.

309. APPLICANT MUST FILL IN BOXED AREA
311. Owner*
313. Address*
315. City*
316. State*
317. Zip Code*
319. Signature of Owner or Authorized Representative*
321. Gross Aggregate Area (Square Feet)*
323. SPECIAL CONDITIONS
325. CONDITIOANL APPROVAL
327. Signature of Administrative Authority
328. Title
329. Date
331. Permit VALID for a period of twelve (12) months from date of issuance by Director of Public Works and all work must be completed prior to the expiration unless authorized in writing from the Director of Public Works.
Leave This Blank:


333. 1. Receive an email copy of this form.
334. Email address

     This field is not part of the form submission.

335. Submit Submit and Print

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