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MAR-01-1999 12:47 MltlMEHAHA CPEB: MATEPSHED 6124710632 P.-02-02,’ <br />J • <br />COMBINED JOLNT NOTIFICATION FORM • WATER RESOURCE APPLICATION . <br />Use this fonn to notify/apply to the Minnehaha Creek Watershed District (MCWD), their engineering consultants,- hr • <br />DNR, and the Hennepin Conservation District of a proposed wutcr/wetland project or work which may fall within hcil -H <br />* ^ -. - . .1 . . • ________j_____1 n nfn tViip ic.—^jurisdiction. These agencies should advise you of their jurisdiction or permit requirements v.itbin 10 day.s. Fill out this <br />form completely and mail a copy, with plan, maps, etc... to the MCWD, Cray Fre.shwatcr Ceuwt, Navane, 2500 <br />Shadywood Road. Suite 37. Excelsior, MN 55331. Keep a copy for your records. YOU MUST OBTAIN ALL <br />REQUIRED authorizations BEFORE BEGINNING WORK.__________________ <br />X ‘ <br />1. /^plicaut’s Name (Last, First, M.I.) <br />Lew.son, Neal. Assistant Superinteudent ISD #27S, Orouo <br />Phone No <br />(612) 449.3300 f ^9 2 6 "lb99 <br />Addrejw (Street. RhD. Box #, City. Stale. Zip) <br />6S5 Old Crystal Bay Road No.. F.O. Box 46, Long lake, MN 55356-0046 »«* > .* * <br />? •*'. •*I IL^V. — • <br />7 Location of proposed project (Attach drawing w/directions 10 sitc):US 12 10 CMd Crystal Bay Rd; north of Suidcct Center, cast <br />COUNTY QTR SECTION(s> SECTlON(s) TOWNSHlP(s) RANGE(s) Lot. Block. Subdivision <br />Henneniu SW'/a 28 118 N 23 W 1&2. 1&2. Orouo School Expansion <br />PROJECT .ADDRESS: Old Crystal Bay Road CITY: OROXO, Minnesota--------- <br />3. LENGTH OF SHORE AFFEClED (in feet): VOLUME OF FILL OR EXCAVATION (Cubic yards): 14,00'J O'! <br />AREA FILLED OR EXCAVATED 1$ 0.902 Acres. OR 39.284 Square Feet. <br />4. TYPE OF PERMIT BEING APPLIED FOR: ((2hcck all that apply): <br />m STORMWAI ER VLVNAGEMF.NT D PLAN FLOODPLAIN ALTER.ATION B WETI^AND ALTERATION <br />n SHORELINE IMPROVEMENT J STORM SEWER OUTFALLS 0 EXCAVATION (DREDGING) <br />a G RIPRAP ^ ''WILDLIFE <br />b. 0 SANDBI.ANKET 4 ICE RIDGE REMOVAL b. □ <br />c. □ RETAINING WALL BIOENGINEERING <br />□ BRIDGE <fc CULVT.RT CROSSINGS <br />OTHER (DESCRIBE) Fill in existing w rtlaud basins .aud Crealiuu of new wetIunJ by excavation (SHE GRADING PLAN) <br />4a. APPUCANT-S REPRESENTATIVE: (Ucensed ContractriTTEnginccr. etc...) Include name, address & phone noml^r <br />Jay Pemeroy. AJA. Inc.. #200 Valley Stpiare Office Cemci, 7575 Cioldcn V.dley Rd.. Golden Valley. MN .*»I-7 (.44-)>3 ) <br />Patricia .%lig. Arlig Environmeutal. luc . P.O. Bo.x 1842, Minnetouka, MN 55345 (612-974♦98^6) <br />5. PROJECT PURPOSE (v/hy is Ihis'^ojecl needed - what benefits will it provide?) <br />Middle School needed for projected coxulluicui aud programs ot the TSD #278 <br />6 AL rF.RNATIVES (de.scribe anv other sites or methods that could be used to achieve the putjiose of your avoiding <br />or minimizing water/wetland impacts. Attach additional sheets, if needed. SEE AlTACHED DOCUMENTATION <br />7. DATES: Proposed start of activity; April 1999 <br />(Identify -Tny completed work, on attached drAwip^l <br />Proposed completion: Scptciubcx 2000 <br />NOaVE <br />S. N.AMES & ADDRESSES OF ADJf llNING PROPERTY OWNERS (Ust provided to WCHD) <br />9. PERMITS have BEEN RECEIVED (R) OR /APPLIED FOR (A) FROM; (uotifi^d JNFj DNR A <br />. ............. r________ t.^ ».-.r,t„ f..r Ki*rvK<;i \fN PDl T.UDON CONTROL AGENCYCOUNTY SVV'CD A CITY ('coatr.ictor'owner to apply for NPOFS) MN POLLUDON <br />I hereby notify tlie tecipicnls of Ou^ Urni of the project proposed herein .uid reque^, I be advised of my ^rmits or oLher <br />Jone^^rUiis ^uuVoceedina with woi;k before all required autJiori.adons ;ue uhtmned nuiv be <br />subjeUtoFodffal, Slate vid/nrl(-culailnuni5iru:ive. civil un'l'or criminal penalties <br />MiiJSS.___ <br />SiebutuVe of P^O!^ru|<osii>^ Project or A^eiit D'-‘v -------------------------------- <br />TOThL P.C.d