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74 STATE OF MINNESOTA A <br />r^ARTMENT of NATURAL RESOURCES ^ <br />Division of Waters, Soils and Minerals <br />NOTIFICATION OF PERMIT APPLICATION <br />i <br />♦ <br />< <br />'4 <br />INSTRUCTIONS FOR THE APPLICANT <br />Minnesota Statutes, Section 105.44, Subdivision 1, requires you to supply a complete copy <br />and all supporting data of your water permit application to the following: <br />A) <br />B) <br />The chief executive officer of the city or township within which <br />the project is located. <br />The secretary of the Board of Managers of the watershed district, <br />if any, within which your project is located or which your project <br />may affect. <br />You WST certify having served the complete application on the above in the box on the back <br />side of the application form W-54. <br />W ADDITION, if your project is NOT located in a city, a complete copy and all supporting <br />data of the application should be submitted to the Administrator of the Shoreland Manage­ <br />ment Program for the affected county. <br />Complete this fora for each notice served on a local government official. <br />SECTION I (TO BE COMPLETED BY APPLICANTS <br />TO: A) Chief executive officer of the (check) <br />SJ city, CJ township of _ _ _ _ _ORONO <br />Tprint or type name) <br />B) Secretary of the board of managers of theMinnehoho Creek watershed district. <br />(print or type name) <br />C) Administrator of the shoreland management program of county. <br />H.R. Johnston, Jr. ^prtnt or type name) <br />925 Willow Drive South <br />Woyzoto, Minnesoto 55391 <br />(print or type name and addreaa of appUcant) <br />Date:November 6, 19 76 <br />4 <br />•i <br />) <br />i <br />INSTRUCTIONS FOR THE LOCAL GOVERN^ENT <br />This report from provides you an opportunity to submit input to the Department of Natural <br />assist in deciding whether to grant, modify, or deny the requested permit, <br />it IS NOT absolutely necessary for local agencies to officially approve or disapprove the <br />project or make any recommendation, although this may be done if desired. It is requested <br />that local agencies i^ndicate the following, as applicable: <br />A. <br />B. <br />The relationship of the proposed project to local plans for the <br />affected water and related land. <br />The relationship of the project to local land use controls including <br />flood plain and/or shoreland regulations. <br />(oontimed on reveree aide)