Wetland Conservation Act application and decision

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i ___---, � Project Name and/or Number: j PART ONE: Applicant Information I I If applicant is an entity(company,government entity, partnership,etc.),an authorized contact person must be identified. If the ; � applicant is using an agent(consultant, lawyer,or other third party)and has authorized them to act on their behalf,the agenYs � contact information must also be provided. Applicant/Landowner Name: Natalie Williams � Mailing Address: 2815 Deer Run Trail,Orono,MN 55323 I, Phone: 415-710-9346 I E-mail Address: np.williams@vahoo.com I Authorized Contact(do not complete if same as above): Mailing Address: Phone: E-mail Address: ! Agent Name: Ken Arndt,Midwest Natural Resources,Inc. i Mailing Address: 1032 W.7th St.Suite 150,St.Paul,MN 55102 I iPhone: 651-788-0641 E-mail Address: ken.arndt@mnrinc.us I '� i ! PART TWO: Site Location Information I ' County: Hennepin City/Township: Orono I Parcel ID and/or Address: 2815 Deer Run Trail,Orono,MN Legal Description(Section,Township,Range): 4,117N,23W j Lat/Long(decimal degrees): Attach a map showing the location of the site in relation to local streets,roads,highways.(See Figure 1 of attachment) I Approximate size of site(acres)or if a linear project,length(feet): 3.1 acres I� If you know that your proposal will require an individual Permit from the U.S.Army Corps of Engineers,you must provide the I1 Inames and addresses of all property owners adjacent to the project site. This information may be provided by attaching a list to ; I your application or by using block 25 of the Application for Department of the Army permit which can be obtained at: i http://www.mvn.usace.armv.mil/Portals/57/docs/re�ulatorv/ResulatorvDocs/engform 4345 Z012oct.ndf PART THREE: General Project/Site Information If this application is related to a delineation approval,exemption determination,jurisdictional determination,or other II correspondence submitted prior to this application then describe that here and provide the Corps of Engineers project number. i Describe the project that is being proposed,the project purpose and need,and schedule for implementation and completion.The ; project description must fully describe the nature and scope of the proposed activity induding a description of all project elements i that effect aquatic resources(wetland, lake,tributary,etc.)and must also include plans and cross section or profile drawings i showing the location,character,and dimensions of all proposed activities and aquatic resource impacts. 7he applicant is proposing to build a swimming pool in their back yard. ' I i I