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NA•02622-02 <br />1.0 <br />N. <br />W. <br />^°" tuet tnit1111111li Ate WATM PAIN A <br />OFFICE USE ONLY <br />OF TO "OK M MUM WATM 00 WE AMA <br />F A.NO <br />ftDEPARTMENT <br />-111NATURAL RESOURCES l � 1AFFT1l <br />C7 SwCD p CSC <br />P. ► Please read instructions before attempting to complete This application <br />LE� W U.; C:1 USCOE <br />Applicant's Name (last, First, M.I.) <br />Authorized Agent (itapplicable) i <br />Tel��ohone Numberaareac <br />WMCH, William <br />John Roble 612-541-9344 x560 <br />( 612) 4.71-0795 <br />Address (Street, RFD, Box Number, City, State, Zip Code) <br />�l <br />Government Lot(s) Quarter s) Sections(s) Township(s) Aange(i Lot, Block, Sub -Division <br />-- - - - - <br />Fire No., Box No. or Project Address <br />County <br />Project will affect Lake, Wetland or Watercourse <br />�OAEts <br />3 APoirt wa sata <br />doaae in <br />! f krf1eio8wn""be` Lalk4 Himnotoota <br />N. PROPOSED PROJECT <br />III. PROJECT AREA <br />❑ fill ❑ excavate <br />❑ dam ❑ culvert ❑ shore-pLoIXtign <br />Ei drain "pnstruct <br />❑ lake n wetland ❑ other is") i <br />❑ remove ❑ other (4,)Cify) <br />❑ wharf (gshoreline ; ,� "� = •, ,J <br />❑ abandon <br />❑ bridge ❑ obstruction <br />❑ install <br />❑ harbor ❑ watercourse <br />❑ riprap ❑ sand blanket �f� � i <br />WATERS <br />MEB RAW. ERAWCKT <br />❑ channel ❑ permanent dock <br />VW EVLAMTMN IF PIWI --- <br />Install 4" ductal iron pipe ground water !seating discharge pipe for a distanme of <br />Approximately 100'. (sae attached site plan)(see attechsd por6it Si-6176 for hater <br />Haistenamae dredging to re reo silt and mmei to eliminate dastsrors aituatioa to be <br />t an re bod same a tics reW" tclr Spo <br />x a n v. noted an drawl" by Colt its E, Gronberg. <br />To provide &afc, yiii,.:,t--tuund t;:Lchatgw point io: outlet for grow.d tut.ct: i-ouyled 1.4.zt <br />ptaml. t lur. <br />��AL NNW (Anticipated changes to the water and related land resources, including unavoidable but detrimental effects) <br />No long-term environmental change to lake bottom or water quality characteristics <br />after construction. <br />ALTMTIrE'f (Other alternatives to the action proposed) -- ---- _.A--- ^---- <br />Discharge oe senate. This will cause a build tip of ice and/or the possibility <br />- of open water in winter. - <br />i hereby make apphcatan pursuant to l/irrfesola 91slulri Chapter 105 42 siW all su WwV rules far a WWA to work In of none! the above Hewed protected <br />waterlsl in accordance with all supporting maps. plans and other 100rmabo i subirntiM with this appiiabon The Oft volion subinmeil &M sta%mwft maAe <br />concerning this aWlica ion are true and correct to Bin best of my knowledge <br />CA9 7e r <br />STATE OF �...�.c . Ao <br />COUNTY (IF urn of Lessee pie <br />Suescribed and Sworn lo belors r>r liz <br />is <br />Distribution <br />Whit DW <br />Mus SWCD <br />My comlliuew etaMw / Grew Watershed ZorITtct <br />_ y —_ (k*lenrod City or Countyy <br />N0 li <br />yi PbYI Army Corps of Er9insers <br />t _' �`' /x'/ �v+ _• -� Canary At4*canf <br />