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Minnesota Weland Conservation Act, <br /> A, <br /> ��)Iication foi- Approval of Wei and Type ad BOLI'ridary <br /> l <br /> 1. Project/Site Information <br /> Project/Site Name: 125 Turnham Rd. Local Government Unit: MCWD <br /> Location (address and/or T, R, Sec.): T 11 8N, R23W, Sec 31 <br /> 2. Applicant Information <br /> Applicant Name: PHILIP R & JOY A ASAO Address: 5033 Avon Dr <br /> City, State,Zip: Mound, MN 55364 <br /> E-mail: Phone: 952-495-8199 <br /> 3. Agent/Consultant Information <br /> Company Name(if applicable): SER Contact Person: Brian Burgner <br /> Address: 25580 Nelsine Drive City, State, Zip: Shorewood, MN 55331 <br /> E-mail: brianb@gpsinnovabons.com Phone: 612-790-5511 <br /> 4. Description of Request <br /> Check all that apply: 10 Wetland Boundary(must attach wetland delineation report) <br /> IN Wetland Type (Eggers & Reed and/or Circular 39 type) <br /> 5. Signature <br /> By signature below,the applicant requests a determination from the Local Government Unit under <br /> Minnesota Rules 8420.0225 on the submitted wetland boundary and type information in this application. <br /> The applicant also affirms that they are the owner of the subject property or have permission from the <br /> er to purs <br /> Ian r j,�e thi rtion. <br /> t or Mffiori!� ent nature Date <br /> Important Notes: <br /> • The applicant may be required to submit multiple copies of the report/information to the <br /> LGU.The LGU may require the applicant to submit copies directly to Technical Evaluation <br /> Panel Members. Check with your LGU regarding dWr submiffal requirenwnts. <br /> • The LGU decision must be made in compliance with Minnesota Statutes,section 15.99. <br /> For LGU use only <br /> Date Received: <br /> Page 1 of 1 <br /> BWSR Wetland Boundary/Type Application Form 11/10/08 <br />