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Project Name and/or Number: SER#2014-022-03—4565 Bayside 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: peter & Sharon Rennebohn
<br /> Mailing Address: 4565 Bayside Road, Maple Plain, MN 55359
<br /> Phone: 952-472-7369
<br /> E-mail Address: prennebohn@msn.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: 4565 Bayside ROad(PID#06-117-23-21-0005)
<br /> Legal Description(Section,Township,ttange): A part of the NW '/a NE 1/4 NW `/a, Section 6, T 117N, R23 W, (
<br /> of Orono, Hennepin County, Minnesota
<br /> Lat/Long(decimal degrees): Lat.44.977683(44°58'39.6588"N)/Long.-93.639104(93°38'20.7744"W)
<br /> Attach a map showing the location of the site in relation to local streets, roads,highways.
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<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/resulatorv/RegulatoryDocs/en�form 4345 2012oct.pdf
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