MN Wetland Conserv. Act - Notice of Application & Decision

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_ _ — _ _ _ - — — — -- - _ .__ _—_ -- -- . � � I Project Name and/or Number: 1050 Edgewood Hills Road I ' PART ONE: Applicant Information �� If applicant is an entity(company,government entity, partnership,etc.), an authorized contact person must be identified. If the � i applicant is using an agent(consultant, lawyer,or other third party)and has authorized them to act on their behalf,the agent's I contact information must also be provided. i I Applicant/Landowner Name: James Robin I Mailing Address: 22732 Olgilvie Avenue Scandia, Minnesota 55073 � I Phone: 612-309-3946 I E-mail Address: jamesrandrobin@comcast.net IAuthorized Contact(do not complete if same as above): I I Mailing Address: ', Phone: II E-mail Address: I IAgent Name: Andrew Krinke I Mailing Address: 26105 Wild Rose Lane Shorewood, MN 55331 'I ' Phone: (952)-401-8757 � E-mail Address: Andrew@kjolhaugenv.com � li � I� i PART TWO. Site Location Information � ' County: Hennepin City/Township: Orono I Parcel ID and/or Address: 0211723130003 � Legal Description(Section,Township, Range): 52 T117N R23W i I Lat/Long(decimal degrees): , Attach a map showing the location of the site in relation to local streets,roads,highways. � Approximate size of site(acres)or if a linear project,length(feet): 1.51 acres II If you know that your proposal will require an individual Permit from the U.S.Army Corps of Engineers,you must provide the I I names 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: II ht�: www.myp.usace.ar�mil .f�ortals�57 docs re ulato��.Regulator pocs engform 4345 2012oct.pdf �� PART THREE: General Project/Site Information II If this application is related to a delineation approval,exemption determination,jurisdictional determination, or other I ' 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 i Iproject description must fully describe the nature and scope of the proposed activity including a description of all project elements Ithat effect aquatic resources(wetland, lake,tributary, etc.)and must also include plans and cross section or profile drawings Ishowing the location, character,and dimensions of all proposed activities and aquatic resource impacts. I Minnesota Interagency Water Resource Application Form February 2014 Page 3 of 11