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// O� <br /> 04 �\, REQUEST FOR WETLAND BUFFER EVALUATION <br /> �v4 f <br /> ,� ,�,��:;?: �� www.ci.orono.mn.us <br /> \� ���#;4�^tiii�,� <br /> ��o� 952-249-4620 <br /> Property Address <br /> Person Making Request: <br /> This person is the: <br /> ❑ Property Owner ❑ Owner's Contractor/Consultant ❑Other <br /> Company Name <br /> Address <br /> City Zip <br /> Daytime Phone <br /> Email <br /> What work is planned? <br /> Signature of person making request <br /> Date: <br /> Staff use only <br /> Date received <br /> ❑ Two copies of delineation <br /> ❑ Two copies of survey <br /> ❑ Two copies of MCWD acceptance <br /> Date sent to Bonestroo <br /> Date report received <br /> Date report forwarded to applicant <br />