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Project Name and/or Number: 790 Brown Ro�d Norih <br /> Joint Application Form for Activities Affecting Water Resources in Minnesota <br /> PART ONE: Appiicant Information <br /> If appiicant is an entity(company,government entity, partnership,etc.�,an authorized contact person must be identified. If the <br /> applfcant is using an agent(consultant,lawyer, or other th(rd party)and has authorized them to act on their behalf,the agent's <br /> contact informatlon must also be provided. <br /> Project Name: '190 Brown Roacl North Orono MN <br /> Applicant/Landowner Name: Gonyea Homes&Re►nodeting;Attn:Jo��CoE�nolly <br /> Mailing Address: 6102 Olsoci Me��iorial Higl��t�ay, Golden Valley, MN 55a22 <br /> Phone: (763)432-4500 . <br /> E-mail Address: ,�gii���n �eacom tanics�com <br /> Authortzed Contact{do nat complete If same as above); Rob Bouia, Kjolhaug Environmental Services Co. <br /> Maifing Addressc 26105 1Vild Rose Lane, Sl�ore�vood, MN 55331 <br /> Phone: (G12)581-0546 <br /> E-mall Address: It�bF���kjolh��u�cii��.coni <br /> Agent Name: Rob Botita, Kjolhaug Environmental Services Co. <br /> Malling Address: 26i05 Wild Rose Lane, S(iore�vood, MN 55331 <br /> Phone; {612)581-0546 <br /> E-mail Address: Etols�r�l:�alhau�ei���,co�n <br /> PART TWO: Site Location Information <br /> County: Hem�epin City/Township: City of Orono <br /> Parcel ID and/or Add�ess; PID; 34-I l 8-23-1 I-0003/AdcCress: 790 Bro�vii Ro�d Noi-th, Oror�o, MN <br /> Legal Descrlptfon(Sectlon,Townshlp, Range}; NE '/a af{he NE '/a of Sectio��34,Township I f 8 North,Range 23 t'Jest <br /> lat/Long(decfmal degrees): 44.991891,-93.S66fl42 <br /> Attach a map showing the locatlon of the site in relation to local streets,roads,h(ghways, See Figut•e 1 <br /> Approximate slze of site(acres)or ff a linear project, length(feetj: i.94 acre <br /> 1f you know that your proposa!will require an indlvidual Permit from the U.S.Army Carps of Engineers,you must provlde the <br /> names and addresses of ali property owners adjacent to the project site. This information may be provided by attaching a list ta <br /> your application or by using block 25 of the Applicatfon for Depar#men#of the Army permit which can be obtalned at: <br /> http:[[www.rltvu.usace.armv mfl/s?ortals S7 docs ra�ufatorv/ft�ulator�Uocs enp,forrz�,4345_ 2017_oct,pdf <br /> PART THREE: General Project/Site Information <br /> If this application Is related ta a delineation approval,exemption determination,jurlsdlttional determination,or other <br /> correspondence submitted prlor to this appllcation then describe that here and provlde the Corps of Engineers project number. <br /> Descrlbe the project that is being proposed, the proJect purpose and need,and schedule for implementatlon and completion,The <br /> project description must fully descrEbe the nature and scope of the proposed activity including a descriptlon af all proJect elements <br /> thai effect aquatic resources(wetland,lake,tributary,etc.)and must also include plans and cross section or profile drawings <br /> showing the locakion,character,and dlmensians of all proposed activities and aquatic resource impacts. <br /> The projec involves a iie�v liome constructior�. <br /> Minnesota Interagenty Water Resource Applicatlon Form February 2014 Page 1 of 3 <br />