Laserfiche WebLink
6/15/2020 <br />I certify under penalty of law that this document and all attachments were prepared under my direction or <br />supervision in accordance with a system designed to assure that qualified personnel properly gathered and <br />evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, <br />or those persons directly responsible for gathering the information, the information submitted is, to the best of <br />my knowledge and belief, true, accurate, and complete (Minn. R. 7001.0070). 1 am aware that there are <br />significant penalties for submitting false information, including the possibility of fine and imprisonment (Minn. <br />R. 7001.0540). <br />Yes <br />By typing my name in the following box, I certify the above statements to be true and correct, to the best of my <br />knowledge, and that information can be used for the purpose of processing my MS4 Annual Report. <br />Name: <br />Title: <br />Date: <br />(mm/dd/yyyy) <br />When you are ready to submit, you must click the 'Submit' button at the <br />bottom of this page. <br />Provide the email(s) of the individual(s) you would like to receive the MS4 Annual Report for 2019 submittal <br />confirmation email from the MPCA. After you click the Submit button below, please allow up to three business <br />days to receive this email. <br />Email <br />(1) <br />Email <br />(2) <br />Email <br />(3) <br />Print or save a copy of your completed MS4 Annual Report for 2019 for your records. The MPCA will <br />email a formatted version of your MS4 Annual Report for 2019 in a confirmation email within three <br />business days after you submit this form to the email(s) you provided above. <br />You may print a copy of the MS4 Annual Report for 2019 for your records by pressing the 'Print' button at the <br />bottom of the page. <br />Additionally, it is possible to save a PDF copy of the MS4 Annual Report for 2019 if you are working on a <br />computer with OneNote (a program often included in Microsoft Office packages). Detailed saving instructions <br />are available at stormwater.pca.state.mn.us/index.php/Guidance for saving MS4 annual reports. <br />If you have any questions, contact MPCA staff Cole Landgraf (cole.landgraf@state.mn.us, 651-757-2880). <br />https://survey.mn.gov/siam/suweylanding/printerviewer.asp?sid=d5a63c444a944513b06ce6125555e1 be 13/13 <br />