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� r r � � r � � <br /> � � � � / � � � / � � � � � ■ � / • <br /> 1. Project/Site Information <br /> ProjecUSite Name: 3759 Casco Ave Locaf Government Unit: Orono <br /> Location (address and/or T� fl, SeC.�. Casco Heigbls 5ubdivision,Lot9 8 10,Block 4,.36 acre sile wnlch i5 parl o�NW lS MW'/. SW'/.SecliOn 20.T117N,R23W <br /> 2. Applicant Information <br /> Applicant Name: Colson Custom Homes - Rod Colson Address: 216 Water Street <br /> City, State, Zip: Excelsior, MN 55331 <br /> E-mail: rodney@colsoncustomhomes.com Phone: 612-275-8871 <br /> 3. Agent/Consultant Information <br /> Company Name (if applicable): Svoboda Eco�ogica� Resources Contact Person: Frank Svoboda <br /> Address: 25580 Nelsine Drive City, State, Zip: Shorewood,MN,55331 <br /> E-mail: franks@gpsinnovations.com Phone: 952-471-1100 <br /> 4. Description of Request <br /> Check all that apply; LO Wetland Boundary{must attach wetland delineatfon report) <br /> �Wetiand 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 /> (andow to pursue this det in o <br /> . � <br /> ���2����� <br /> Applicant or Au horize ent ignature DatT <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 appiicant to submit copies directly to Technical Evaluation <br /> Panel Members. Check with your LGU regarding their submitta!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 t <br /> BWSR Wetland Boundary/Type Application Form 11/10/08 <br />