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<br /> h'A-026G20�038
<br /> Minnesota Locai/State/Federal A lication Form for VlrateriViletiand Pro ects �7
<br /> Appliratioa Ivo. ficld Otlice Cudc For TntcrnAt'ETse O�tly
<br /> Date initiat Appitcaiian Recet��ed `p��(��i�q�j,catian Deerttcd Camptetc
<br /> �see I��.P"directs�vn to Importnnt addition�!infammtion nnd a�ss�G,in t�ns��us�n�APPLIGATIDItF ���EIi/ED►
<br /> ,�e!. .
<br /> i• LAiVDO�YfVE[UAiPPLICAl\T CONTACf INFOIi14IATI0T(Se�Relp Ij
<br /> Name: Wayzata CountryCfub;8ob Distai ,��,�J � 8 Z��Q �
<br /> Completemaitin�address;2fl0 Wayzata BIVB.West,Wayzafa,MN 5539'I phone: 952-4T5•9761 E.ntail:
<br /> lrl. AUTHQItIZEDAGBl1'T CiTY OF ORONO �
<br /> (See Xelp!�i) (O�rl��lfapplrcnble;au ogeirt!s�iot regulredj �
<br /> Numc: MFRR;Tedd Ullom Plione: 783-4?6•6010
<br /> Comptcte mai[in�address: 14800 28"'Avenue N,Su'tte 1A0,PtymoUtFt,MN 65q47 �'ntaiL•lullotttQmfra.cort� '
<br /> 2, N�i11�tE,TYPE Al4`D gIZE OF PUDLtC tVATBCtS o�•►YGTI A'�tp5 Ii4rnpCTL•'il(Attecti Aridlrtonai Prv,iect Area shcets ifnecded) f
<br /> t�ame ot I.D.#of I��atars Impaciecl�'if npplicable;if kno+��it):
<br /> {Chcck alf that npply): ❑Lnke ❑ni���r ❑Girculnr 39�Vctland type:[] I,[] IL,�y,�3,Q q,�s,��,�7,Q 8
<br /> tt'etlnnd pinnt community typc': ❑shollo���opan watcr,[�decE�nt�rsh,Q shallo��nt�rsii,�scdge�ncsdo���.�fresb tn�ado�r�
<br /> ❑���e�to�t�et•mesic prriiric,�crlcareous fci�,�open bag or canEferous bog,�s�l�ub•carr/Aider ihickd, !
<br /> ❑hnrd�vood s�s�amp or conifarous s�t�t�t�p,[j floodplain forest�[]scasnnally ftoockd basiii
<br /> Tndicate size of entirc Iake or�ti�tttand(check one): Qx Lcss ttu�n f 0 ncras(indlcatc size:+!-Q,7 R�) ❑ 10 to 40 acres
<br /> 8� ❑Grettter than 40
<br /> 3. PROJECT LOCATtQN (b forrtraliar can Ge jorutd o»praperryltir slafemen(,pr•operty lille or litle iiutrra�tce): '
<br /> Praject streei address:200 Wayzata Blvd.West,Wayzata,MN 55381 ;
<br /> City(iCapp►icnble}:Orono rire#:
<br /> '/.Seclion:S1t2 Sectinn:36 To�t7lship f1:11$N Range R:23W �
<br /> �t�: B1oc�. Gount��Nennepin i
<br /> Subdivision: �Vatcrshcd(nante or�)#20 UTM location:N � t
<br /> Attuclt a simple sIte locfltor map. If tteedcd,lnctude ou thamnp��ritten directiau to the site ironz n l�oua�Ioct�tton nr lundmarl;,uqd
<br /> proeide dist�nccs!'rom kno�va localloi�s. Lnbel the shcet S/TL LOGlTOR,tli1P.
<br /> d. T]'PE Or PROJECTt Describe t(ie t�pc of praposed�tivrl:, Att:►ch Tl'PEOFPROJECTslicet if�tcedcd. k
<br /> Construction of a pond within a golf course.Pond wlil be consUucted v1a excavation of an existing drainage ditch anct InstaUafion of a i
<br /> weir,Mitigation of wetland Impacf wfl!be provtded on-site as itlustrated on the attached plan sheets. ;
<br /> S. PRQJEGTPUftP05G,DESC[tTPTIQN AND DI1IEl��STOPtS: Describe��•liat you plan to do mtd�vliy it isneedcd,han�you plan to 7
<br /> construct ihe projcct�vith dinicnstons(kr�th,u�idth,dcpth),aren oCinzpact,snd�t�}ten you proposeto cnizstruct theproject. This is the
<br /> mast httnortnnt pnrt of your npplication. See HELP 5 Leforo campleting tLis seciion;seo 1VIEnt To Includa on Pfnns(Instnictions, �
<br /> pagel). AtiacltPROJECTDESCItIPTIO��rshcct.
<br /> The purpose of the proposed proJeci(s to construct a stormwater pond within an existing drafnage ditch on the su6ject property.The `
<br /> stormwater pond w�l!provide addilional treatment oi stormwatar enerated b ttte olf ceurse and nei hboriq f
<br /> entering Lake Minnetonka,subsequenfly tmproving surface wat 9 quality af�rn,vn s eam waterbodies,WeOa dpmfl gation v il be
<br /> provideii on-sife.
<br /> Footprinl ofpro;cct: 0.19 acres or$,341 square fctt draiaed,filled or cxcsrutcd.
<br /> 6. FR�JGCT}II,TLRi�,tT11rES: �Vtiat efternnti��es to this proposed project ha��e��ou considered Uiat tti•oiiid a��oid or niinimize iinpRCts �
<br /> to n•eAands or�vute�sT I:ist at lense T1V0 ndditional alfcmnti��es to your Nrojcct in Sectioct 5 ttial a��aid��•etlands(one af�vhicli ma��be"no
<br /> build"or"do natl�ing"),nnd exptnin�vhy yau chase fo pursuc the option desc�ibed in this applicntion at�er these atterndtives, AtEncli
<br /> PROJECTdLTER1rATlPCSshe�t ifnccded.
<br /> Please see attached narrative
<br /> 7. ApJOIh't1VG PROPGRTI'(?��'NERS: For prujects thnt In�pact u�ore tl�at�10,0U0 sc�uere ftet af��ater or��xttands,list the complcte '
<br /> mailing eddresscs ofadjacent property ownCrs on an nttnched sepnratc shcet, (Sre Ii�LP 7) '
<br /> 8. PORTIQN Or\VORIC CUAIPLETED: Is tui��portion of the tivork in�rclland or�vatcr areas alr�ndy compl�ted7 (�yts No. !f
<br /> �•cs,describe tl�e compteted�ti�ark on a sepnrnte slieec of pnper labeled 1VOEtK pLRF.Ab1'GOhiPLETEb. (Sec FIELP 8) O
<br /> h�9 S11TU5 Or QTHER APPR01'ALS: List any ottim•pern�ies,rovie�+•s or appro��als related to this proposed project that ar�eithcr pdnding or
<br /> ve nlrendy brcn sta�rro►�ed or denled on n selinrafe nttncliect sUcet. See HGLP 9.
<br /> 0. I �m a��plying[br st�te anat tocsrl nuN�orizntion to cmiduct Iho��•ork descrlbed in il�is�pplicntion. Y�in faniiliar with tl�e inform i
<br /> aitai�c in this appl`catiol�. To thc best oCtliy};r�n�s(edgc�u�d belief,a!1 informAtiott in PArt I is tn►c,complete�and aecurn(e, 1 poss ss���
<br /> t ie&ul t �to unde ke UlII�vo •de cribed,or I ttm ncii�tg as th�dttly t�uthorized agent of tl�e applirant:
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<br /> y ! +l^ f(} (oJs.�..�_ /-!3-t U
<br /> Signaltrre pJnpp!lcart!(LaudouolerJ Date Slg�rattrre ojage�t�(jappllcnbleJ Dnre
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