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- • - • • • ' <br /> ' • � • • ' • • � • - • • - • : � • . <br /> 1. Project/Site Information <br /> Project/Site Name: Thomas Bren Homes Inc. Local Government Unit: Minnehaha Creek Watershed District <br /> Location (address and/or T, R, Sec.): 475 Oxford Road, Orono, MN 55356 <br /> 2. Applicant Information <br /> Applicant Name: Carter Ohrt Address: 475 Oxford Road <br /> City, State, Zip: Orono, MN 55356 <br /> E-mail: Phone: (612)919-4457 <br /> 3. Agent/Consultant Information <br /> Company Name: Anderson Engineering of MN, LLC Contact Person: Ben Hodapp <br /> Address: 13605 1st Ave North, Suite 100 City, State, Zip: Plymouth, MN 55441 <br /> E-mail:bhodapp@ae-mn.com Phone: 763-412-4000 <br /> 4. Description of Request <br /> Check all that apply: 0 Wetland Boundary (must attach wetland delineation report) <br /> 0 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 /> /�..w� f��/�� 05/01/2013 <br /> Applicant or Authorized 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 <br /> Evaluation Panel Members. Check with your LGU regarding their submittal <br /> 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 />