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Project Name and/or Number: <br /> PART ONE: Applicant Information <br /> If applicant is an entity(company,government entity, partnership,etc.),an authorized contact person must be identified. If the <br /> applicant is using an agent(consultant,lawyer,or other third party)and has authorized them to act on their behalf,the agent's <br /> contact information must also be provided. <br /> Applicant/Landowner Name: Jon Norris <br /> Mailing Address: 2080 Webber Hill Road,Orono,MN 55391 <br /> Phone: 612-963-3953 <br /> E-mail Address: jon@oxbowhardwoods.com callymorr@aol.com <br /> Authorized Contact(do not complete if same as above): Mark Gronberg,Gronberg&Assoc <br /> Mailing Address: 445 North Willow Dr.,Long Lake,MN 55356 <br /> Phone: 952-473-4141 <br /> E-mail Address: markg@gronbergassoc.com <br /> Agent Name: Bopray Environmental Services LLC, Kelly Bopray <br /> Mailing Address: N7831 920th Street,River Falls,WI 54022 <br /> Phone: 715-307-4577 <br /> E-mail Address: kjbopray@yahoo.com <br /> PART TWO: Site Location Information <br /> County: Hennepin City/Township: Orono <br /> Parcel ID and/or Address: 460 Orchard Park Road,Orono,MN 55391 <br /> Legal Description(Section,Township,Range): Part of the SW'/.,N/W''A,Sec.32,T118N,R23W <br /> Lat/Long(decimal degrees): <br /> Attach a map showing the location of the site in relation to local streets,roads,highways. <br /> Approximate size of site(acres)or if a linear project,length(feet): 23 acres <br /> If you know that your proposal will require an individual Permit from the U.S.Army Corps of Engineers,you must provide the <br /> names and addresses of all property owners adjacent to the project site. This information may be provided by attaching a list to <br /> your application or by using block 25 of the Application for Department of the Army permit which can be obtained at: <br /> http://www.mvp.usace.army.mil/Portals/57/docs/regulatory/RegulatoryDocs/engform 4345 2012oct.pdf <br /> PART THREE: General Project/Site Information <br /> If this application is related to a delineation approval,exemption determination,jurisdictional determination,or other <br /> correspondence submitted prior to this application then describe that here and provide the Corps of Engineers project number. <br /> Describe the project that is being proposed,the project purpose and need,and schedule for implementation and completion.The <br /> project description must fully describe the nature and scope of the proposed activity including a description of all project elements <br /> that effect aquatic resources(wetland,lake,tributary,etc.)and must also include plans and cross section or profile drawings <br /> showing the location,character,and dimensions of all proposed activities and aquatic resource impacts. <br /> Lot subdivision, with one minor wetland impact that is less than the deminimus exemption allowed. <br /> The wetland delineation was previously approved by MCWD (App.# 15-46). Corps of Engineers <br /> concurrence project#2015-02825-MMJ. <br /> Minnesota Interagency Water Resource Application Form February 2014 Page 3 of 11 <br />