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Project Name and/or Number: <br /> PART ONE: Applicant Information <br /> If applicant is an entity(company,government entity,partnership,etc.),an authorized contact person must be identified. If the <br /> applicant is using an agent(consultant,lawyer,or other third party)and has authorized them to act on their behalf,the agent's <br /> contact information must also be provided.. <br /> Applicant/Landowner Name: Vt 044 TAI`l N P-V W'tm P44, <br /> Mailing Address: i56 0 (,EuJ000 <br /> Phone: &c 'k - 15th- 04e)9 <br /> E-mail Address: 'EDI(:)t1 & ,•1 -, <br /> Authorized Contact(do not complete if same as above): pQj \1lprC,�,�,�t.F^,,, /' <br /> Mailing Address: (Z,ZA fo \104043G1C.,t "r7tn R4PA_ DP-046,. -S Ajth e Df_ to Int <br /> Phone: �r�Z_2,%1-1 , -666-1 . <br /> E-mail Address <br /> Agent Name: <br /> Mailing Address: <br /> Phone: <br /> E-mail Address: <br /> PART TWO: Site Location Information <br /> County: Hennepin City/Township: Long Lake <br /> Parcel ID and/or Address: 1560 Tanglewood Road <br /> Legal Description(Section,Township,Range): S26 T118N R23W <br /> Lat/Long(decimal degrees): 44.999349/-93.561652 <br /> Attach a map showing the location of the site in relation to local streets,roads,highways. See Figure 1. <br /> Approximate size of site(acres)or if a linear project,length(feet): 3 acres <br /> If you know that your proposal will require an individual Permit from the U.S.Army Corps of Engineers,you must provide the <br /> names and addresses of all property owners adjacent to the project site. This information may be provided by attaching a list to <br /> your application or by using block 25 of the Application for Department of the Army permit which can be obtained at: <br /> httn://www.mvo.usace.army.mil/Portals/57/docs/regulatory/RegulatoryDocs/engform 4345 2012oct.odf <br /> PART THREE: General Project/Site Information <br /> If this application is related to a delineation approval,exemption determination,jurisdictional determination,or other <br /> correspondence submitted prior to this application then describe that here and provide the Corps of Engineers project number. <br /> Describe the project that is being proposed,the project purpose and need,and schedule for implementation and completion.The <br /> project description must fully describe the nature and scope of the proposed activity including a description of all project elements <br /> that effect aquatic resources(wetland,lake,tributary,etc.)and must also include plans and cross section or profile drawings <br /> showing the location,character,and dimensions of all proposed activities and aquatic resource impacts. <br /> The project proposed for the site is construction of a tennis court and access path on the subject property. The location of the <br /> tennis court was selected because it is the best spot on the site where adequate land is available. Figure 2 illustrates the <br /> overall project. The access path is a necessary component of the project,and it involves a very small wetland impact. <br /> Minnesota Interagency Water Resource Application Form February 2014 Page 3 of 11 <br />