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3. Indicate by answering "Yes" or "No" whether the project will include alternative methods for the permanent Stormwater management system or will disturb 50 acres or more and have a discharge point (including sheet flow) that is within 2000 feet of and flows to an impaired or special water. Additional review from the MPGA is required in these cases. Yon have the option of proposing an alternative, innovative, permanent Stormwater management system. YOU must send in the permit application and the additional required information (see Part 111,0.5 of the Permit) at least 90 days prior to the start of construction if you choose this approach. You must receive an approval letter from [lie MPCA for this method before beginning construction. The application and SWPPP need to be submitted to the IVIPCA a minimum of 30 clays prior to the start of construction if the project disturbs 50 acres or more and drains to an impaired water or a special water listed in Appendix A of the permit. For a list and maps of impaired waters in MN go to www.pca.state.mn.us/water/trndl.html 4. The application requires a S400 application fee. Indicate that the application fee has been enclosed by answering ""yes" Please make checks payable to: Minnesota Pollution Control Agency and submit the check with the completed application to: MPCA, Regional Environmental Management Division, 520 Lafayette Road North, St. Paul, MN 55155- 4194. Applications received without the required fee will be returned to the sender. 5. List the construction project's name. If the project does not have a name, list the type of project and a brief description (for example, "I -35E/1-494 Interchange" or "Highway 169 bridge replacement (#79605) at the Rum River"). 6. Provide an address (if available) and brief description of the construction activity's location (for example, "North West Corner of the Intersection of 45"' Street and Irving Avenue, Minneapolis, MN-). List the County Parcel ID# for the project if it is known. If there are multiple numbers within the project, attach a list. Parcel identification Numbers are unique numbers assigned by the County. Listing the County Parcel 1D4 is not required if not available (for example, highway projects) Provide the names of all Cities, counties, and townships the construction activity takes place in (for example, a roadway may cross county, city, or township boundaries). 7. List, in acres, the amount of area to be disturbed for this project. 8. Attach the required map and indicate that it is included with the permit application. United States Geological Survey (USGS) 7,5 -minute quad maps or equivalent maps may be used. USGS 7.5 -minute quad maps may be ordered at http://store.usQS.gov/ 9. Indicate the type of construction activity by checking the appropriate box. Please describe the project if you check "Other". 10. Indicate to the nearest quarter acre, the existing and resulting areas of impervious surfaces. Impervious surface means a constructed hard surface that either prevents or retards the entry of water into the soil and causes water to run off the surface in greater quantities and at an increased rate of flow than prior to development. Examples include rooftops, sidewalks, patios, driveways, parking lots, storage areas, and concrete, asphalt, or gravel roads. (a.) "Existing" area means the area of impervious surface that is present prior to the start of this construction project. (b.) "Post construction" means the entire area of impervious surface after construction is completed. Subtract (a.) from (b.) to determine the area of new impervious swrface. 1 I. For projects creating one or more acres of cumulative new impervious surfaces, check the appropriate box to indicate which type(s) of permanent Stormw2ter management practices that will be used. The "Other" box is limited to those situations (such as proximity to bedrock) that are described in Part I11.0 of the permit. See the permit for a further description. 1f the "Other' box is checked, describe which situation outlined in Part 111. C. tits the project and what other permanent treatment (such as grassed swales, smaller ponds and/or grit chambers) will be used on the project. 12. BRIEFLY describe which waterbody(s) will receive Stormwater runoff from the construction site or from the discharge from permanent Stormwater management systems by completing the table. To determine which waterbody(s) will wq-strm2-58 Revised 1 P06