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E NA-02GG20-038 (V.2.02 for NiS W02D)09/01/04 <br /> Minnesota Local/State/Federal A lication Form for Water/Wetland Pro'ects, � � <br /> For Internal Use Only <br /> A lication No. Field OfFce Code Date Initial A lication Received Date initial A lication Deemed Com lece <br /> PART I: BASlC APPLfCATION � <br /> "See HELP"Qirects you to important addittonal informnUon and assistance in Instructions,Page 1. <br /> 1. LAND04VIYER/APPLICANT CONTACT INFOI2IVIATIOIV(See Help 1) <br /> Name: Ryan Companies US, Inc. (Kenneth Vogel) _ Phone: (612)492-4635 . <br /> Complete mailing address: MPLS, MN 55402 <br /> IA. e�UTHORIZED AGENT(See Help IA) (O�ily iJapplicable;a�t age�tt is nol required) � <br /> Name: Liesch Associates, Inc.(Mark Miller) • Phone: (763)489-3100 <br /> Complete mailing address: 13400 15'�Avenue North Plymouth, MN 55441 <br /> 2. NAIVIE,TYPE AND SIZE OI'PUI3LIC WATEIt,S or WETLANDS IlVIPACTED(Attach Aclrlitia:al Project Area sheets if needed) <br /> Name or I.D,#of Waters Impacted(if applicable;iEknown):N/A <br /> (Check all that apply): ❑Lake ❑River �Wetland type❑ l ❑ iL ❑2 �3 �4 ❑5 ❑6 ❑7 ❑ 8 <br /> Indicate size of entire lake or•wetland(check one): � Less tltan 10 acres(indica[e size:0.14 ac.)�10 to 40 acres ❑Greater dian 40 acres <br /> 3. PROJ�CT LOCATION (1�forma�ion can be foiuid on property lax sta�emeitt,property tille or title iiistiratice): <br /> Project street address:2725 Wayzata Boulevard West Fire#: Cily(if � <br /> applicable):Orono <br /> '/a Section:NE Section:33 Township#: 118 Range#:23 County:Hennepin <br /> Lot#:001-004 [ilock:001 Subdivision:Van Dale tiVatershed(name or#)3 <br /> Attach a simple site locator map. IE needed,include on the map written directions to dte site from a known location or landmark,and <br /> provide dis[ances from known locations. Label the sheet SITE LOCATOR A�IAP. <br /> 4. TYPE OF PROJECT: Describe the type of proposed work. Attach TYPE OF PROJECT sheet if needed. <br /> Construction of an office warehouse building. . <br /> 5. PROJECT PURPOS�,DL�SCRLPTION AND DIlbIENSIONS: Describe what you plan to do and why it is needed,how you plan to <br /> construct the project with dimensions(]ength,width,depth),area of impact,and when you propose to construct the project. This is the <br /> most important part of your application. See HELP 5 before complefing this section;see What To Include on Plans(Instructions, <br /> page 1). tlttachPROJECT'DESCRIPTIONsheet. <br /> Refer to Attachment A-Supplemental Information Sheet. <br /> Footprint of project: 0.14 acres or 6,000 square feet drained,filled or excavated. <br /> G. PROJ�CT ALTEI2NATIVES: Whut alternatives to this proposed project have you considered that would avoid or minimize impucts <br /> to wetlands or waters? List at least TWO additional alternatives to your project in Secdon 5 that avoid wetlands(one of which may be"no <br /> build"or"do nothing"),and explain why you chose to pursue the option described in this application over these altematives. Attach <br /> . PROJECT ALTERNATIVES sheet if needed. <br /> Refer to Attachment A-Supplemental Information Sheet. <br /> 7. ADJOINING PROP�RTY OWNEI2S: For projects that impuct more than 10,000 square feet of water or wetlands,list the complete <br /> mailing addresses of adjacent property owners on tu►attached separate sheet. (See H�LP 7) <br /> 8. PORTION OF�VORK CONIPLETED: Is any portion of the work in wetland or water areas already completed7 ❑ Yes �No. If <br /> yes,describe the completed work on a separate sheet of paper labeled 4YORK ALR�e1DY CONIPLETED. (See E�ELP 8) <br /> 9. STATUS OF OTH�R APPROVALS: List any other permits,reviews or approvals related to this proposed project that are either pending or <br /> have aIready been npproved or denied on a separate attached sheet. See HELP 9. <br /> 10. T am applying for state and local authorization to conduct the�vork described in this application. I am fanuliar with tlte information <br /> contained i this appl' ation. To the best of myknowledge and belief,all information in Part I is true,complete,and accurate. I possess <br /> tlie autho ' to un ak he work described,or I am acl•ing�.s the duly authorized gept oF the a� i t. <br /> � <br /> ��'��'6 p'�. h�'�1R:1: s� %l,S'�iY'h"- !=� Z`-�d 5-\ <br /> Signalure o pplicant(Landotiv�ier) Date Signature of agent(if applic Gle) Date <br /> r�, <br /> This btock must bc signed by the person who desires lo undertnke the proposed uctivity und�us tite necessary property rights to • s :..��f'�t�e�'�ggdt IiaS�Si`�,ed," <br /> ti v .?�.,- <br /> please attach a separate sheet signed by tlie landowner,giviog uecessary nuthorization to tlie Agent. f • . .. ,. �-•- <br /> J <br /> `,•+�� pl � ':., f <br /> Minnesota LocaUState/Federal App(icution Forms for WatedNleUnnd Proj,��f� . � �lit1�� ��_� �i�y� L <br /> Page 1 E. �� wi�•.�., „ ( L�� <br />