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Project Name and/or Number: Nelson Restoration Project(AES 12-0975) <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: See Attachment 1 <br /> Mailing Address: See Attachment 1 <br /> Phone: See Attachment 1 <br /> E-mail Address: See Attachment 1 <br /> Authorized Contact(do not complete if same as above): Dr.Glen Nelson <br /> Mailing Address: 500 Tonkawa Road,Orono, MN 55305 <br /> Phone: (952)473-0333 <br /> E-mail Address: gnelson@tonkawa.com <br /> Agent Name: Douglas Mensing(Applied Ecological Services, Inc.) <br /> Mailing Address: 21938 Mushtown Rd, Prior Lake, MN 55372 <br /> Phone: 612-202-2252 <br /> E-mail Address: dougm@appliedeco.com <br /> PART TWO: Site Location Information <br /> County: Hennepin City/Township: Orono <br /> Parcel ID and/or Address: 520,630&550 Tonkawa Rd, Long Lake, MN 55356 <br /> Legal Description(Section,Township,Range): SW Y.of Section 5,Township 117,Range 23 <br /> Lat/Long(decimal degrees): 44.968308/-93.624132 <br /> Attach a map showing the location of the site in relation to local streets,roads,highways. See Attachment 1 <br /> Approximate size of site(acres)or if a linear project,length(feet): 2.98 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 /> http://www.mvp.usace.army.mil/Portals/57/docs/regulatory/RegulatoryDocs/enp,form 4345 2012oct pdf <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 /> See Attachment 1 <br /> Minnesota Interagency Water Resource Application Form February 2014 Page 3 of 9 <br />