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Project Mame and/or Number. SERt!2015-043•03—2445&2455 Narth Shore brive Orono � <br /> , <br /> PART THREE: General Project/Site information <br /> � If this epplication is related to a delineation approval,exemption determination,jurisdictional determination,or other <br /> correspondence submitted p�lor ta this applicatior�then describe that here and provide the Corps of Engineers project number. <br /> i Describe the project that is being proposed,the project purpose and need,and schedule for implementatlon and completion.The <br /> prajed desc�iption must fully describe the nature and uope of the proposed activity including a description of all project elemenis <br /> that effect aquatic resources{wetland,lake,t�ibutary,etc.}and must also Intlude plans and cross section or profile drawings <br /> showing the iocation,tharacter,and dimensions of all proposed activities and aquatic resource impacts. <br /> ; <br /> The owner wa�ts to know where the approved edge is lopted before starti�the planning process.As soon as approval is � <br /> recei�ed they will move forward with their qra)ect. C <br /> PART F�UR: Aquatic Resource Impacti Summary <br /> ' IF your proposed project involves a direct or indirett impact to an aquatic resourte (wetiand, lake, tributary, etc.) identify each <br /> Empact in the table below. Include all anticipated impacts, including those expected to be tempo�ary.Attach an averhead view <br /> map, aerial photo, and/or drawtng showing all of the aquatic resaurces in the project area and the location(s}of the proposed <br /> impacts.Label eath aquatEc resource on the map with a reference number or letter and identify the impetts in the follawing table. <br /> uatic Resouroe �'atk Type of Impact Duration of ��g p�� <br /> Cou�►,MaJor <br /> � � = Overall S�e of �mmu Watenhed fif, <br /> ID(as noted on Resource Type {fi11,excavate, Im �e��m�� ��� � �nd Bank Senri ' <br /> overhead view) ���and,lake, draln,or remove Permanent�P)0 3 'fype(sy in Impa 1 <br /> tributary etc.) vegetatfon) Temporary(T�l R�� Mea ��af Impact � <br /> AreaS � <br /> °If fmpacts are temporary;e�er the duradon of the impacts in days next to the"'T'. For example,a project wkh a temporary acress fill that would be removed <br /> � aher 220 days would be entercd'T(220}`. <br /> 'Impects less than 4.01 acre should be reported in square feet. impacts 0.02 acrQ or greater should be repoited as acres and rounded to the nearest 0.01 a�re- <br /> Tr{bntrry impacts must!�e reported in Iinear feet of impact and an area of impact by indfwting tirst tha linear teet af impact�bng tfie flowline of the stream <br /> followed by the a�a impact in parentheses). For e�cample,a project that impacts SD teet of a stream that is 6 feet wide would be reported as 50 k(300 sq/R). <br /> �This Is generally only applltabk it you are applying for a de minimis exemptio�under MN Rules 8420.OA20 5ubp.8,othervWse enter"N/A". <br /> �tlse WedorM PloaLs ond Plont Corr�munlry Types of Minnesota and Wtscovulo 3id Ed.as mpdtfied In MN Rules 8420.8405 Subp,2. <br /> �Refer to Ma�r Watershed and Bank 5ervlce Area maps in MN Ruks 8420.0522 Subp.7, <br /> If any of the above identified impacts have already otcurred,identify which fmpacts they are and the circumstances associated <br /> w(th eacii: <br /> PART FlVE: Applicant Signature � <br /> F <br /> � <br /> ❑ Check here if you are�equesting a pre-anoltcation consultatfon with the Corps and tGU based on the�nformation you have <br /> � provfded, Regulatory entities wilf not initiate a formal application review if thls box is chetked. <br /> � By signature below,i attest that the information i�this application is complete and accurate. I further attest that I possess the <br /> � authority to undertake the work described herein. <br /> Signature; ��'`"`� d �r'"'`— Date: November 16,2415 <br /> I hereby auth ze oboda Eco! cal itesources to act on my behalf as my agent i�the protessing of this appNtation and to <br /> furnish,upo est,su al or tion in support of this applitation. � <br /> � <br /> 'i'he "im used in this nt appliratton form is a generic term used for disdasure pu►poses to identify <br /> ac#ivities that may requtre approval om one or more regufatory agencies. For purposes of this form it is not meant to <br /> � indkate whether o�not those activities may require mitigatloa/replacemen� <br /> � <br /> � <br /> � ��-----.�_�__. .._��.._.__._� ___.__w_.. .._—_____...__T�—_.___ ____ <br />