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a, �, <br /> .. _ `" �� " ` _ <br /> i " i ! � i � <br /> �' �� r� � ; � �'� f r �! � - �" i � r� *� <br /> 't. ProjectiSit� lnfarrna�ian <br /> � Prajeci;'Site hlame: 24f� 8; 2485 t�. Shc�re Driv� �.ocai G�vernmeni Unit: �CI�J�i.� <br /> Location (address ar+elor T, R. Sec.): T1�7ti! R23t�� Sec. � <br /> 2. A�plicant �nfarma#ion <br /> �pplicant tvame: i;rown Construction {Eiisabeth Hoff} Address: �(B8 Seymou�-�w� <br /> City, Sta�e,�ip: N3ir11leapo[is, MN 55474 <br /> E-mail: �lisa��thC-er��mmr�.con�� Phone: 612-812-1938 <br /> 3. Agent/�or�sulta�t Infiormation <br /> Campany Nam� tif apRlicabie): SER Contact P�rson: Brian Burgr►et` <br /> .4ddress: 2�58G f�elsine Drive City, State,Z;p: Sht�rAwoo�, f�JIN, �533� <br /> �-mai1: brianb@c�psinnova#ivns.cam Phone: �i5�-�71-110G <br /> �. descr��tic�n o€ RQc�vest <br /> vhecic all thai ap{�iy: C1 Wetland Soundary{must atYacli wetland defineation report} <br /> D Wetland Type (Egg�rs & Ree� andlar Circul3r 39 type) <br /> � <br /> �. �i�nature <br /> By signature below, the applicant requests a determinati�n firom #h� Local Governmeni Unit under� <br /> Minnesaia Rules 8420.0225 on the submified wettand boundary and type information in this application. <br /> The applicant alsc affirrns that they are the av��er Qf the subject property or hav�permission fror�n ihe <br /> landovvner to pursue ihis determination. <br /> .�, rii r -'- �i t ' � <br /> P�, cant� l�utho,�t�,. ;�,gen_ S�gnaiure Date <br /> fmpartant Nfltes: <br /> � The appiicant may be required to submii mul;i�le copies oi the report/iniormation to i"e <br /> LGU. Tf�e LGI: may require the applicant to submif copi�s direcfia�to Technicai �valuafivn <br /> Pane(Members. Cbeck wi�h your LGU regarding thei�submft#at r�quirements. <br /> + The �GU decisian musl b� �r1ade in compliance wi,h #�inneso��Statutes; section 15.�39. <br /> For LCU use only � <br /> Date Fieceivet�: � <br /> 1 <br /> �, (� � � <br /> __ _ __ <br /> �age 1 C�f 1 ��� M?, IUr �E il �% 5 ��'1 <br /> GWS� 'dVetlan�Eocfndary,�TypE��plicaiior� r=o�m ;�� ��t ,; '�,;z;; t��� �: �,,fli�� <br /> �;i; • _ <br />