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r <br /> r <br /> r <br /> � 5 1Q,\S-PLEASE READ CcUWEU LY <br /> A COI?}'OI Itis fond with copies of alI plans.dian'iagi.c:C. .t119}'ueed 10 be'c'!11 t0.aU 1>v"CS1C1'II1thCAld�l belan... Fleas cltet <br /> file:ytptt,lninlr sllacei hrlon'In shote ei rn ttlicr'e}ou ur se►uling this fonts Remen her lu keep a copy fir y'colr re4mds <br /> [3 \INNESOTA POLLUTION CONTROL AG EM\•0IP(Al for NPDE'S phase 11 pennil <br /> The L.UC'.�L C;CiVFRNAiF'�fAl UNIT�LGt�I.cit}'.couutyrn n��ter nunnagemenl oraanixatinrl <br /> rn\11KNESOTA DEPARMENT OF NAWRAL RE-,0 RUES 1\mDNR)Re_'ion,l Office <br /> LIS A.RD{`_'C'URPS OF ETGINFrRS(:1C`Ol <br /> it Dept.of the Alnty.C 0111,5 of L'ncaieers. 5t.Pawl Disnid <br /> ATIN,CO-R- 1'.N]Fifth St En;r.St,NO,XIN'5101•i6�C <br /> rNotes The alw a Agatcie�may ptovicle a cePy of}our complelexi foram to the Miluiesom Pollution C'onRc•I Ageticy i\1PCA,, <br /> ARCA nater gt'alin'recluucrllerlts ILMY aPPIV to}t,t+r Proposal project. <br /> r A7"ft NTION 0,trol►l'SD )=Arlt'nctll'l'}'UtChklUtg dlaltu.8t.dl'erlgUl�.fiiltns.let'ell►ls cl other nL�ngnlLltiotis.i►►chlJing <br /> Inniluellalto Lamy at?ect a land uwr's eligibility for USDA benefits rider the 1985 Food Securirti'Act as artls•►ide.1.Check wilh <br /> your local USDA office to legtlest atld complete Foml AD-1026 ptiot m milialum actit rty <br /> -- - - --- -- <br /> . . <br /> Appllcnno:l i%hereby I11liIC tOr a i1C►Illit to a10111DI I!lire nCllrllle`descr ibed hereat. I ce►tify Iliat I 11116 waliar will MC A'D <br /> Rules aad:hat the p opo;ed aclivity will he condacted in complamce trill, line Ruses,l'tut fauuliar i0l,the iidoi almtilm <br /> r caltained i d' al�licatiotl aii&to die best of my l m►nletlee and belief.nil itifomintim is true-CmIliAete Uhl aclmate.I <br /> h:Miler celV! fhnr I pos-ess the a lllholity to midetiake the prot)o%eil activity or I am actuig os the duly autacinzed agent of TIM <br /> aI>t?lican <br /> r -7/1/1j"I 1-04 7� <br /> Si a of pplicautI-Propc•tty0mierl D. Sipikmmlre�fMe11t Wit <br /> r .•OTE,The ipplicaitou must be smied by the property rvvmer where the laoposed activity►s to oalu The apphcalim tomy be <br /> ;igned by a dilly ntullotizeil iigeat if a letter beaiiiw the o►igutal simmture of the prtq�eny ottrLt':s cuhmina)omiim flint lire <br /> It Yen►noted ill the peluut aP1:6Cation is the nu010lized deem of Ill.la idowim for all matters relaliiiu to tha pelutit. Please <br /> ' protide authorized agenl iakinuation below <br /> .Aeenfo,Naure ti title.Dopray Environmental Services.LLC.Kelly Bopray, PSS, MVQ <br /> ragent's.Addres N7831 920th Street River Falls,WI 54022 <br /> �genl's Teltt�lturla 1715 1307-4577 <br /> r1 S U.S.C. 5ectloll 1001 plot'rd a that Miele•,et.m any maivici wobi l jluisdiction of auy Jep ilivelit or agency Of the Ullited <br /> Stales lawxiugl 'and nillftltly Ldsifres.couceals or covets op by ally nick.scuenle.or drrice a ulatetial faCl a►bakes 1;m. <br /> false. fidiaou or fitut&i:ent statenteuls or rq)'escmalious o.ilrakes or uses my false wiitulg docs►ttieta lu mviiie smue to <br /> r collnill un'fake.lictitimi: or fr-111rhilem slatenrew ni entry. shall be fined col More Iliac S 1-1.00 or Illpis sled not more that: <br /> five years.er both. <br /> r <br /> rPage 2 of 2 <br /> r <br />