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Project Name and/or Number: SER#2014-002-03 -4505 West Branch Road,Orono <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: Renee Wixon <br /> Mailing Address: 2375 E Medicine Lake Blvd <br /> Phone: 763-458-7997 <br /> E-mail Address: rvwixon@gmail.com <br /> Authorized Contact(do not complete if same as above): Frank Svoboda—Svoboda Ecological Resources <br /> Mailing Address: 22752 Co Rd 7, Hutchinson, MN 55350 <br /> Phone: 612-384-7770 <br /> E-mail Address: franks@gpsinnovatitons.com <br /> PART TWO: Site Location Information <br /> County: Hennepin City/Township: Orono <br /> Parcel ID and/or Address: 4505 West Branch Road(PID#0711723210014) <br /> Legal Description(Section,Township, Range): Gary Lindgren Addn , Lot 1, Blk 1; A portion of NW 'A NE 1/4 <br /> 1/4 of Section 7, T117N, R23W, City of Orono, Hennepin Cour <br /> Minnesota <br /> Lat/Long(decimal degrees): Lat.44.962981/Long.-93.639038 <br /> LW NW Hrpnrnlid(kW PeN p Attach a map showing the location of the site in relation to local sti <br /> roads,highways. <br /> .,\, \ 0 <br /> iiii„, <br /> 4114W , - ...' , ,A. ha; 7----, ,4 -7 ' , <br /> r . <br /> in,. .,.±1 . <br /> \. . __. <br /> Approximate size of site(acres)or if a linear project,length(feet): 9.5 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/RegulatorvDocs/engform 4345 2012oct.pdf <br />