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<br />List all current MPCA permits or certificates. and their numbers, which also tnay apply to this facility: <br /> <br />Ifthists a new or expanded facility. has an Environmental Impact Statement or an Environmental Assessrnent Worksheet been prepared? <br /> <br />yes 0 no k8J If yes. note the ti [Ic and <br />date: <br /> <br />Annual Permit fee invoice should be mailed to 0 O\vncr/Opcralor address 0 Facdity location address 0 Nut applicnble <br />Discharge Monitoring Report forms should b,,'mailed to 0 Owner/operatOl:,address 0 Facility location address 0 Not applicable <br /> <br />""Amlk~{2i&ctl@~.~EES <br /> <br />An application fce is required under MinIL Stat. So J 16.07, subd. 4d (1990) and Minn. R. ch 7002 (Perlnit Fee Rules). <br />This application fee must be submitted with the permit application. <br />A1JTJUcation fees are as follows: <br />Sanitary Sewer....................... $240.00 <br />Construction Storm water ...... $240.00 <br />All other applications [including llOn-construction storm water) $85.0{) <br /> <br /> <br />/J..pplications that are submitted without all authorized signature, the required application fee, and attachments <br />will be returned. Please make your check payable to the Alinnesota Pollution Control Agency. Send the <br />completed permit application, attachments (including plans ami spec~ficatiolls, ~l applicable) and check to: <br /> <br />Minnesota Pollution Control Agency <br />Water Quality Division <br />Point Source Section <br />520 Lafayette Road North <br />St. Paul. IVlinnesota 55155-4194 <br /> <br />For more information please contact: <br /> <br />In [vIetro Area: \Vater Quality Division Customer Service Center at (651) 296-7162 <br />Outside IVletro Area: 1-800-657-3864 and ;;lsk for \Vater Quality Customer Service Center <br /> <br />Pa~t~ 2 <br /> <br />tmnsmiJUaJ t<xrn FEf3 'IX <br />