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• Version 2/99—editorial con�ections May. 0� • ENVIRONMENTAL ASSESSMENT WORKSHEET Note to preparers: This form and EAW Guidelines are available at httn://www.eqb.state.mn.us. The Environmental Assessment Worksheet provides information about a project that may have the potential for significant environmental effects. The EAW is prepared by the Responsible Governmental Unit or its agents to determine whether an Environmental lmpact Statement should be prepared. The project proposer must suppfy any reasonably accessible data for — but should not complete — the final worksheet. 1 f a complete answer does not fit in the space allotted, attach additional sheets as necessary. The complete question as well as the answer must be included if the EAW is prepared electronically. Note to reviewers: Comments must be submitted to the RGU during the 30-day comment period following notice of the EAW in the F.QB ,ti�onitor. Comments should address the accuracy and completeness of information, potential impacts that warrant further investigation and the need for an EIS. 1. Project title Proposer Cent Ventures Contact person John Livingston Title Partner Address 1660 Highway 100 S, Suite 500 City, state, ZIP St. Louis Park, NtN 55416 Phone (612) 272-1246 Fax (612)395-�530 E-mai l livingston@cognoscente.biz 4. Reason for EAW preparation (check one) EIS scoping Mandatory EAW Citizen petition X Proposer volunteered RGU Contact person Title Address City, state, ZIP Phone Fax E-mail RGU discretion If EAW or EIS is mandatory give EQB rule category subpart number NA and subpart name 5. Project location County Ramsey City/Township Roseville '/4 '/4 Section Township Range Legal Description: Lols Fozir(4), Five (�), Sixteen (16) ancl Seventeen (17), Block !3, Tivin G''ieiv all according to the plat Ihereof on file and of record in the �f�ce of the Regisler of Deeds in and for Ramsey Counry, Minnesotn, subjec� to easements of ��eca�d. (Tax pai•ce! +:) 0-l-029-23-33-0002 Attach each of the following to the EAW: • County map showing the general location of the project; Previously prorided Ciry s�q�% • U.S. Geological Survey 7.5 minute, 1:24,000 scale map indicating project boundaries (photocopy acceptable); Pi�erious/y provided Ciry staff. • Site plan showing all significant project and natural features. Preriozrsly submit�ed to C'ity sruff. 6. Description a. Provide a project summary of �0 words or less to be published in the F.QB :tlonr�a•. Develop a I20 extended stay hotel and a �, 000 sqzrai�e foot high quality - eal in restau�•ant on a sile used for en�pry trarler stoi•age. The derelopment u�il! r•esult in a redvction of the imperrious surface. b. Give a complete description of the proposed project and related new construction. Attach additional sheets as necessary. Emphasize construction, operation methods and features that will cause physical manipulation ofthe environment or will produce wastes. Include modifications to existing equipment or industrial processes and significant demolition, removal or remodeling of existing structures. Indicate the timing and duration of construction activities.