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BWSR Forms 7-1-10 Page 3 <br />of 3 <br />and are available from the LGU upon request. <br />Name <br />Rachel Workin <br />Title <br />Permitting Technician <br />Signature <br /> <br />Date <br />12/14/2016 <br />Phone Number and E-mail <br />(952) 641-4518 <br />rworkin@minnehahacreek.org <br /> <br />THIS DECISION ONLY APPLIES TO THE MINNESOTA WETLAND CONSERVATION ACT . <br />Additional approvals or permits from local, state, and federal agencies may be required. Check with all <br />appropriate authorities before commencing work in or near wetlands. <br />Applicants proceed at their own risk if work authorized by this decision is started before the time period <br />for appeal (30 days) has expired. If this decision is reversed or revised under appeal , the applicant may be <br />responsible for restoring or replacing all wetland impacts. <br />This decision is valid for three years from the date of decision unless a longer period is advised by the TEP <br />and specified in this notice of decision. <br /> <br /> <br />3. APPEAL OF THIS DECISION <br />Pursuant to MN Rule 8420.0905, any appeal of this decision can only be commenced by mailing a petition <br />for appeal, including applicable fee, within thirty (30) calendar days of the date of the mailing of this Notice <br />to the following as indicated: <br />Check one: <br /> Appeal of an LGU staff decision. Send <br />petition and $0 fee (if applicable) to: <br />Minnehaha Creek Watershed District <br />15320 Minnetonka Blvd <br />Minnetonka, MN 55345 <br /> Appeal of LGU governing body decision. <br />Send petition and $500 filing fee to: <br /> Executive Director <br /> Minnesota Board of Water and Soil Resources <br /> 520 Lafayette Road North <br /> St. Paul, MN 55155 <br /> <br /> <br />4. LIST OF ADDRESSEES <br /> SWCD TEP member: Tony Brough <br /> BWSR TEP member: Ben Meyer <br /> LGU TEP member (if different than LGU Contact): <br /> DNR TEP Becky Horton; Kate Drewry <br /> DNR Regional Office (if different than DNR TEP member): <br /> WD or WMO (if applicable): <br /> Applicant (notice only) and Landowner (if different): Anita Lancello Bydlon (YMCA) <br /> Members of the public who requested notice (notice only): Todd Ullom (Sambatek); Jessica <br />Abernathy (Sambatek); Heidi Quinn (MCWD); Wes Boll (Wenck Associates); Chris Mattson <br />(City of Orono); Melanie Curtis (City of Orono); Mike Gaffron (City of Orono) <br /> Corps of Engineers Project Manager (notice only): Melissa Jenny – <br />melissa.m.jenny@usace.army.mil <br /> BWSR Wetland Bank Coordinator (wetland bank plan applications only) <br /> <br /> <br />5. MAILING INFORMATION <br /> For a list of BWSR TEP representatives: www.bwsr.state.mn.us/aboutbwsr/workareas/WCA_areas.pdf