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W4-<nnr»gi Local * State * FspcmL Waie ^ Rtsouwct Pbojcct N ottficapow / a >wjcation Fowm <br />U m 0i« fofm u notffy/applY to tho U.S. Anny Cofpo of CngiMoro. ttw Miwomu Ooponmont of Noturri Rooowrooo. onf your UoRI i u-*. <br />of o propoood wotor/woflond profoct or work which moy foU within thoir Juriodickon. Thooo oponeioo olwtdd odMoo you of tfwlr h-'TitBd"'" <br />ro«iit«monu within 4S dovo. Somo LGU o moy doo ro^uifo oubmiooion of thoir own ipp«orton fomio. P9 out tNo fonn oorrod«dy wd m!a T2T <br />tiSn’SSSA'^SSs’SfoiriSl.SlN^^ ~r-y~youmu»totTAM*awouimd ’’ <br />AGtMCY USE ONLY: LGUNUMBOI:MOfW HUM <br />•i.'. <br />Applicant'# Norn# (Loot. Rrot. M.IJ AuthYiUod Apam, if «iy <br />Hennepin County Transportation Division; Theis, Steve <br />— — w ^ y ■ V A ^ <br />*612* 930-2528 <br />Addr#4# IStroot. RFO. Box Number. City, Stott. Zip Cod#) <br />320 Washington Avenue South, Hopkines, MN 55343 <br />Q. Leeaden of propotod pro)oct tottoeh drtwina thewing hew to got to oito)Hennepil! Countv. City of Orono <br />COUNTY <br />Hennepin <br />QUARTER SECnONIa) <br />T118N, R24W <br />SECnONSto) No. TOWNSHIRto) No. RANGCM No. <br />Sec. 36 T118N, R23W, Sec 31.32 <br />Lot. Btock. tubdidoi#n <br />FIRE No.. BOX No.. OR RROJECT ADDRESS <br />N/A name of waterbody affected end NUMBER OF KNOWN) <br />N/A <br />m.estimated PROJECT COST: » 3,225,000 00 length OF SHORE AFFECTED On foot): <br />IV."X-----^/ Aeroo. OR Sguoro Foot <br />WOTi: yptf may ptAftftidp AnoMoono) <br />V.TYPE OF WORK AND AREA CCHECK Aa THAT APPLY): <br />□ CONSTRUCT □ DRAIN □ EXCAVATE <br />UQLL □ REMOVE □ REPAIR <br />□ Aoens Path □ <br />□ Dooc <br />□ LAKE <br />□ cuwir <br />□ SHORELINE □ WATERWAY <br />□ D am <br />JtWD <br />OTHER (DESCRIBE): <br />WETLAND TYPEIS) AND ACREAGEIS) PROPOSED TO BE FUJLED/DRAINED: (see attached Plans 1 _____________ <br />Attoch appGcablo drawingo, piano, and ASCS crop phetoo. Iftdudo a doocriptfen of any propoaod eomponaatory midgaiion. Iwoortont: Idandfv <br />th¥ tfopotol and borrow ofooa. Dotenbo the worti bolow: how it would bo done; whM oquipmant would bo utod. <br />I <br />VI. PROJECT PURPOSE (why ia thio project rwodod-whot bonoRu will It prov(do7): <br />Improve public safety by the addition of turn lanes, bypass lanes and paved shoulders. <br />VII. ALTERNATIVES (dorcribo any other ti’ao or methodi that could bo Utod to achiava the purpoaa of your projoct whila avoiding Of fidnimixing <br />wadand/watar impact#: Attach oddibond sheota, if neadad). <br />No build alternative is not feasible due to safety concerns. <br />VIII. DATES: Propoaod aurt of activity; <br />Spring,1998 <br />(Idandfy any computed work on an attached drawing) <br />Proposed cocnpl«Tion: <br />Fall. 1998 <br />IX. ADJOINING PROPERTY OWNERS (Attach Uat H mora than two) <br />Name AddreaaSee attached^s*t Chy Sut« <br />ONR ^X. PERMITS have boon racaivad (antar an fl) or alraady appliad for (antor an ^ from: __ <br />_A_Towh /City a WATPgrm Dcnaer ___MN PotumoN CoNmo. AcorcY <br />Haa an archoaological aurvay of the projoct aita been done? N ao. by whom: GrOUP Ltd. <br />COUNTY <br />1 htrtby notify tho rodpUnts of this form of tho pro{set proposed hsrsin and rsquoot that I bo odviood of ony pormhi or othor dotomdMtiono <br />oonoomlng thio oroioct that I must obtain. I undorotand that procoading with wort baforo al raquirod aMthortzationa art obtainod may ai^lact ma to <br />Fodoral. Suu.^d/or local adminiatrativo. oivfl and/or oriminai panahiaa. <br />/i <br />Signatura of Panon Propoaing Pro)act or Agant <br />< < < PLEASE CAREFUUY READ AND COMPLETE BACK OF FORM> > > <br />DATE:7//// <br />(Revised