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Minnesota Wetland Conservation Act <br /> Application for Approval of Wetland Type and Boundary <br /> 1. Project/Site Information <br /> Project/Site Name: 665 Orchard Park Rd Local Government Unit: Orono <br /> Location (address and/or T, R, Sec.): Portion of the Se 1/4 Of Ne 1/4 Of Ne 1/4 Section 31 T118N R23W <br /> 2. Applicant Information <br /> Applicant Name: Bill & Mollie Reynolds Address: 5248 W 106th St <br /> City, State, Zip: Bloomington, MN 55437 <br /> E-mail: molliewr@gmail.com Phone: 612-940-5747 <br /> 3. Agent/Consultant Information <br /> Company Name (if applicable): Svoboda Ecological Resources Contact Person: Frank Svoboda <br /> Address: 25580 Nelsine Drive City, State, Zip: Shorewood,MN,55331 <br /> E-mail: franks@gpsinnovations.com Phone: 952-471-1100 <br /> 4. Description of Request <br /> Check all that apply: 1=1Wetland Boundary (must attach wetland delineation report) <br /> ❑x Wetland Type (Eggers & Reed and/or Circular 39 type) <br /> 5. Signature <br /> By signature below, the applicant requests a determination from the Local Government Unit under <br /> Minnesota Rules 8420.0225 on the submitted wetland boundary and type information in this application. <br /> The applicant also affirms that they are the owner of the subject property or have permission from the <br /> landowner to pursue this determination. <br /> Applicant or AuthoYized Agent Signature Date <br /> Important Notes: <br /> • The applicant may be required to submit multiple copies of the report/information to the <br /> LGU. The LGU may require the applicant to submit copies directly to Technical Evaluation <br /> Panel Members. Check with your LGU regarding their submittal requirements. <br /> • The LGU decision must be made in compliance with Minnesota Statutes, section 15.99. <br /> For LGU use only <br /> Date Received: <br /> Page 1 of 1 <br /> BWSR Wetland Boundary/Type Application Form 11/10/08 <br />