|
SENT BY: dNR METRO; y- 8-97 1�: 13a �12772i5i3 =� �12473��10; #8�11
<br /> 11_IL-._'�-1'�'?� 1�':l-tr ^lltl'vEHAHA C:REEk:: I�.IATER'�H�1r r�l���1t=�r���� f'.�1�� ���
<br /> i. f � i Vv v s
<br /> i , -
<br /> z _ --- � - � ■W�el
<br /> �'[���g�N�.❑ .iC]il+�T N�TI]rICAT�ON �'UIt�N �Wt�,�'ER Tt�sO�}1xC1� A'Px'i...1CATTClt�]
<br /> ' ,� it�Cir ex�ginee,nng Consn4r_ants,thc
<br /> ��t
<br /> USC this fpm� to statifylA�t��Y to the t�4j�neh:�tsa Crcek Wate�-shcxl Ilistrir_t (MC��1(U),
<br /> y" UNi� a�d tl�e HCnctepin Cot�servation t�istrict af tl�elrru sdictianlorepermit req�i re�ments wi hi�t(i da}'s,1l=iil o���d�lsr
<br /> � �: jurisdiCti�n..'These agestcias Stt�uld ad�is� you t .. u�o MCW�a,C�ruy �'xeshwatcr Genter, Navars'�, 25(}D .�sliadyv�rc,vd
<br /> �; foTrtt cbmpletciy �n�il a copy, wid� ptan, ma� , �+��K
<br /> w.�`��RShiEi:� []I.�TR4G"r
<br /> Anad, St,ite �7, Rxcet�;�r, MN 55331. Ke�p a�oUv f.ur yout'recotcl5,�'Ott M�_�ST OI3TAT1`7 ,M11�
<br /> ' � FC�TNG WOR4�, __ _ T
<br /> � AU7�bRE�A"[�!«NS I3EFC1R7`r. 'RF,C ��,�,,.„ _.
<br /> � ,�� �r- __-- t��st,r�rst,1,n i � � --_.—._. Pt�on�No �� T'�-j�_'�'�
<br /> ��- 1. AQP1ic:or�t's Na„�c ( ���� '
<br /> ����' Cit�. 5t3sla, 7.�p) � � �
<br /> �, Addre�.a(Slrcal.�'L7 �3Ox �. ,
<br /> ; ��-_ �,,�.��=.
<br /> �, S..oCalloII of�7ropt�SetS pCU�e4i(/'�l[uCh drawine iv/dit�clions to site}: . tiANt1F(�;} I.ot. R1nck, Sobdi�'�r���n��
<br /> .' COU�'Y QTR SECTt��N(sl S��'IE)l�(s) T�1WN5HTP(s) �/ p "" l
<br /> '� ��'`��� �j�- :/�7 �� ���
<br /> �>. pr�c�r�GT Anr��sfi: -,����
<br /> � ` 3. 1.rL-��iC3-{�Z UC�SHOT2.� �EC�['L7U Iin �ei.t): V(�LUMB O�FILL f]R EXCA11AT10N (L:ub}t�ynrds):
<br /> - AREA�ILLED Q�EhCAVATE�i IS A�r;•S,f�l� Squ�rc Fect.;� �jo'� �
<br /> i• ! _.......�-_. ""_��"'�
<br /> ; a. T'�'FE��'�E�vtr�r E�Et2aC;.nF+A1.r�L5�oR: c�neck al►i�a�r�p�y}.
<br /> � ['� S`l`C1RhTWA'1'�R MANAc3�MLNI'P!_AN � ['I.00)TJF'T..A1N /lL"fE�AT1C�N L} WF,TI,ANU AS..'TTcRATIG:�
<br /> S..
<br /> :'�,: U5HG1tELiN�' ��i1'I20'l�Ali'k=Nl �STlIRM S�.'�/�1�OiJTFA�[..5 Gxl;A1�'AT��2d (Ia}�Ei�GfN�>>
<br /> �. \k'l�u�iF�
<br /> e.{]F�TPR h�' b�qVll:xAT1C3tJ
<br /> , � h.f]SA.NU$LAri14t:'F r}3C�,kir�tit:FLL•MQVAL
<br /> c.pR�`r�ir,rnJc; wA3.t. u [�,��1QENG1�1�,�.l�lhv
<br /> , �;�3RSnC�� &c_►i�.vER�f CRt�SSiNGS �'
<br /> �. _.—
<br /> ' U1'I-a��t (UESf'RiLiE) �--
<br /> i. ' � _ _�,,.—�_ --- _..� .. �—.. . ..
<br /> 4a. A.pl'LCCANT'S R�Px�S�N� ---
<br /> �, �.. _� _ _— ---
<br /> � 'AT1VE' (L.1�cascd Contr�+cter, �n�lneelr, e1�...} �nCllt{�C 11RT1�C. f G4���SS�l1bU.
<br /> ,ti
<br /> �; � , � �
<br /> j� � • �� �
<br /> _ - '`—�..�...�r,Q.r�'i._•,.`,�"��
<br /> � . Pk�O��cr rUP�osF («•hy is tl�is piu,�cc� nced:� -wha�t bcne£��ts wi�l it prav►d�')
<br /> y �/�� � � u_� -�l .L1J v r✓
<br /> ��:, � fi. ALTk�NAT1VLS (des�tlbc:rny o�l�er si�c_� nr irteth+ads 4hal tetifd E�e a�sed to achieve ttie pur�i�sc oi yo�,r pro,je�t �'lii�e ��vaid
<br /> _. ar minln�izin�w++tcrh�Ctl��►d in�pacts. Atl[�chi additioFtaal sk»ets, if ncuitd.
<br /> a:
<br /> ti'
<br /> �.I-� c�C�
<br /> 7. bA"[F_S: Pro�o��d sv►rt of'aelivil5, �� � Pfil�?OSeC�COnkplGlfG�n � T• ff / ��
<br /> , : ��aeniify ans� cn,n��le�cc3`vnrk o�t a�lac�i�d dr-aevingl w____ __ -�_
<br /> "•'" g. NAMES � ADDTLL55F_D OF ADJ(UiN1Ni; �'EZA�'�RTI'�WN�RS (At[A�h lis:t if tnarcl
<br /> �' �_ _ . _.
<br /> ., .�.�
<br /> � , ._�..--- ---- _.,..
<br /> _�� �
<br /> �. .__�_ _ � _,.._�-..�--
<br /> -. _ __--
<br /> I +, �._._.. ...... - t�NR ..__� A�z�.�Y t":l7FtPS OY' EI'�lCiR
<br /> ..._...�—�� _ . _ ...
<br /> ' � PE.RMI'T�HAV� $EF.I4 [tEC�,1VF� (�?c�R nrFLI�T]�'utt(A) r��n-t .-�_
<br /> '� . GOL7NT'l _. U L'i' . .-- �'�h! YULLU'1"�Ohj CONTRDI At,ENt:Y
<br /> y,: �_.—
<br /> , r � -- �._ �
<br /> � -... . __.,�
<br /> .�.,�__--
<br /> 1 hcreby ne�+fy t2►e rc�+pients af t!►ls f�m�of il�r.pr�jeC� PYpP°sed hcrcin and rWucst i UC adv�5ed of any perm ts�r o �c�
<br /> dr..ter��iinraut�� coiiceming stiis pra,iCct 11��1 � must obtxl►i i uiti�erstand llt�t proc����ig wltt����aik t�tfr�G�all requ'trcd au�1�:+�r.a
<br /> I � ��pt��u�i»cd may he stEhject !0 1'edc[,�1, Sta1e flndJor yoeal�dr►1<<;lsU'etive, civil �utd/�r�riminnf}�e�l�tties.
<br /> , :
<br /> , _ � � T � �
<br /> ' , .
<br /> �
<br /> . .�. r � . 'y .....� ....T—
<br /> Signb�i+ue af Q�is�t+I'crspa inEProject or Agenl - --�_�... --- Ddl� _ _ _.,,
<br /> � _
<br /> ` ; ---
<br /> .,—.. _...._. "
<br /> I
<br /> i � _ , . - _�,
<br /> �?- �4 ��7 1 1 : i';t RECE I V t'_€) f'f1(.}M : 61:!471 �682 P • 9?
<br />
|