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•DNR MLTRO REGION TEL �612-772-7977 Jan 08�96 10 �44 No .005 P.02
<br /> NA.O?bT0-0! �.pc:� STA� FEv�►t. WA�REsovnc� P�co.�BCT No�►now !A�ucAn� f�
<br /> Vq this torm to notifyhpply lo thf V.S.Army Corps of Enp�neers,siro WGnns�ota Oepanna�t of Naa,r.l R��europ,end pour LocN Go+r�aanM�t NMt
<br /> oi s propoRsd w�t.r/wedand proj.cc or work whkh m�y f.li withtn thd�juri�diotio�. �.•���shouid sdvis�you of thNr�d�dlotion o�P�mit
<br /> roqu�rementa w�thin 4S days. Som•tQU'*may eleo rsquin wbrtde�lon of tMt�own�ppNc.don fo►ms. FN out thie Mrm compl�tsly�nd m�9 s oopy.
<br /> with pl�m,mps,eto.to��h ai the eqetwies fist�d on ths rovene of ths form. Kap e copy tor you�noords. YOU MUST OBTAIN ALL 11EQUIREO
<br /> AUTHORITATtONS BEFORE 8Efi1NNtNG WORK.
<br /> G.NCY S ON Y: LQU NUMBER: MD�Nt NWI/�E11: D C011r8 NUMliER:
<br /> 1. Applk�nCs N�rr+�tlwt.Flr t,M.1.� Autiwri=�d Aqa�t H�nY Mq Cod�.TN�phom
<br /> � '� -T��.�i S�����r,-�;� R Qr � � � _ �- �--�
<br /> roos tSiro� RFD.9ox Nwnbsr,City. ats, C el • ��+1
<br /> Z. �c�.l1.e v�►eW �c�e.in �c�..v� �1� � 'i
<br /> II, iocatlon of propo�d prokct{meoh drawin��howirro how to pet to ait�! �`� ��G�,�� • � •� �c,C�t-!"ta�
<br /> COUIVTV QUARTER SECTtO[Mlc? SECY10�(•1 No. TOVYNSHIPts)No. RAN�I�No. lot, Blook, Subdivklon
<br /> � �
<br /> fIRE No'BOX No.,OR PROJECT A��ESS , �'`L�i�TERBODY AF�FE�CTEO a�d�e�Go��1 z�' ( ��.
<br /> (�E Ccvhc..Y c� 1+n�c'�icX► Rc� K.e ''� 13���
<br /> NI. ESTIMATED PRO.►EC'T COST: i�O �� '� LENOTH OF 6N�tE AFFECTEO pn h�q: �
<br /> IV. YpLUME OR FiL1,OR EXCAYATION(CuWo Ysrd�i: �'„ a�'�(..� 1� • (1VOTE.• You mRy�vbsN�ut�d6nr�r►a'vn�)
<br /> AREA fIL1,Ep OR EXCAVATED t3 Acros.OR 6qwrs Rset
<br /> v. TYPE OF WORK ANO AAEA tCNECK All THAT�PatY): O ACc�t�i P�rn O BNDOE p Cu�vErt O Dn�
<br /> �.�„R�jCT O RA�N VAT O DOCK O RIP11l►P �SANOY�AM�ET
<br /> O� O REMCYE D REPAIR
<br /> , ��KE L7 SHO O WA�� O�NQ
<br /> OTHER(QESCRIBf1:�U��� "�-�-`�7 1'w+M�77._
<br /> YVE7LANP nPEcs!AND ACREAGE�SI PROPoseb To BE RtIEDNRAtNED: ,�1�
<br /> nn�eh applicable d�swing•,p��m.ond ASCS orop photo�. Indud�s deaoelptlon of e�y propo��d comPernato�y mitiputiqn. e�t nt: 1 �U
<br /> �nr di000cal and borrow_�� do�e►ihe the work bafow: how k wvuld be dons:what squ�n�snt woutd b�uesd.
<br /> VI. PROJECT PURPOSE twhy�is this projsct M�d�d-•what beneflts will it�+�m�id�71. '� G, vU�(� �l�_!idlQ. C6✓ "�2�
<br /> �G�CA� C��\ �5 Gl �'�s�,..�,� �w� a-d � diodCS tc� t�� ��{e.�.t� pc;,bl�c;.!�',Nc,i,� �o.�.P �
<br /> xcu�-�2 u.� ekt�e� laciC t� � ucL.� �a�-�cas�e{ u� p�b►�� ctrcrLSs -1 a lmics� �ay��,r�{� �1��.
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<br /> YII. ALTERNATIVES ldesorib���W oth�r�itN or methods tMt could b�und to�a eve tM purpo�s of you.proj��t whN wof�no et ny
<br /> woUarMlwater impaats: Aes�h odditlonal shNts,if n��d�d1. '
<br /> � ts is C�� �L}e.r nc��e.. si4-G�oM a p i rce. cF�-�� o�i�q��►1ct U�� c,l.,asc.d �►•+�.±�ecs
<br /> W��(�e �-►�an.ec� is ���e �r�i�a+o,�,� --re ^��c_� � ol� a� �-�u� �:'�v`�- .
<br /> OIG� S.���?f' 0��� G�t�t\.2C Jp $CX4^�L. ' 4� 'C1i:r�l � �d� cf1 G�A 'l.c.Klt, IA�C
<br /> b 1
<br /> Vt11. DATES: o��d start M sodNt�►: �,. � Propw�d compNdon. �1��� 1G���
<br /> (W��tify a+y eted vrork on�n�tt�ch�d d��wl 1
<br /> iX. ApJOININ6 PRO�ERTY OWNER3 (Attech Il�t If tnoro tha►two}
<br /> ��n� '.1' �/Y�1�1 Y1Q"���l(' A-7��t 1V �J�'x.,L1P �ti• �ty iT n�"tl Nl N �7�"^1�
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<br /> X. PERM{ have been rsoeiv�d(��N+R)or N»ady eppll�d for ta+ta an$1 hom: DNR ,_,�ANMr Colpi ol�ENe�EERs _COtRITY
<br /> _TOWNlCt1'�' _WATfRlilEO 016TPoCT __MN POI.WT�ON CON►NOL AOENCY
<br /> Hsi so srchAsolopec�►w►v�y of Ihs projsct Nts bsen donsl G'l M w,by whan:V� � `��
<br /> 1 Mnsr�mt(r tM++etpMne�et tlas lenn oi tM�roy�at v���h.►.in.ed rpuNe dNt'1 br NYli�O.of�r PKmIM e►e1f�N�do�w
<br /> tl�l.peeJ.ot th.t 1 nwn obi.in. 1 und.rwed th.t poo..eN�q wflb aralc�Nen�I tpule�d�utl�oAr��Noni•an eba4wd a�.�r.u6J�ot n�eo�.Nr�l.st.a.
<br /> a�d/ar local�dminbtatM.eiv��rW/o►arNnkNl pNNItHs. '�a ��''i�
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<br /> �W�W`�� \ v'�i�; !yJ` ��, DATE: ����W _
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