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Minnesota Wetland Conservation Act <br />Application for Approval of Wetland Type and Boundary <br />1. Project/Site Information <br />Project/Site Name: Wachman Parcel Local Government Unit: MCWD <br />Location (address and/or T, R. Sec.): T117N, R23W, Sec 6 <br />Applicant Name: Bill Coffman <br />2. Applicant Information <br />Address : 201 East Lake Street <br />City, State, Zip: Wayzata, MN 55391-1695 <br />E-mail: Phone: <br />3. Agent/Consu ltant Information <br />Company Name (if applicable): Kjolhaug Environmental Contact Person: Melissa Barrett <br />Address: 26105 Wild Rose Lane <br />E-mail: melissa@kjolhaugenv.com <br />City, State, Zip: Shorewood, MN 55331 <br />Phone: 952-401-8757 <br />4. Description of Request <br />Check all that apply: X Wetland Boundary (must attach wetland delineation report) <br />X Wetland Type (Eggers & Reed and/or Circular 39 type) <br />5. Signature <br />By signature below, the applicant requests a determination from the Local Government Unit under <br />Minnesota Rules 8420.0225 on the submitted wetland boundary and type information in this application. <br />The applicant also affirms that they are the owner of the subject property or have permission from the <br />land~ue~on /O/zZ/!Z- <br />, <br />Applicant or Authorized Agent Signature Date <br />Important Notes: <br />• The applicant may be required to submit multiple copies of the report/information to the <br />LGU. The LGU may require the applicant to submit copies directly to Technica l Evaluation <br />Panel Members. Check with your LGU regarding their submittal requirements. <br />• The LGU decision must be made in compliance with Minnesota Statutes, section 15.99. <br />For LGU use only <br />Date Received: <br />Page 1 of 1 <br />BWSR Wetland Boundary/Type Application Form 11/10/08