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i <br />7 .n _,~..y t ~ <br />t ~~ <br />t` --~ /f ~ ~ --~ <br />{ 1 ~ ( ~' J ~ <br />Version 2149 -editorial co~-~-ections May, 05 <br /> <br />I~€~te to preparers: 't'his form and EAW Guidelines are available at httts.Jlw~ ~ :'~.state.rrrn.us> The <br />Environmental Assessment Warlcsheet provides information about a project that play have the potential for <br />significal7t enviromnental effects. The EAW is prepared by the Responsible Governmental Unit or its <br />agents to determine whether an Environmental Impact Statement should be prepared. The project proposer <br />must supply any reasonably accessible data for -but should not complete -the final worksheet. If a <br />complete answer does not ft in the space allotted, attach additional sheets as necessary. The complete <br />question as well as the answer must be included if the EAW is prepared electronically. <br />Dote to renewers: ColYUnents must be submitted to the RGU during the 30-day comment period following <br />notice of the EAW in the E_OB ~I7onitot°. Comments should address the accuracy and completeness of <br />information, potential impacts that wal-rant further investigation and the need for an EIS. <br />1. Project title <br />Proposer Cent Ventures 3• ~~~ <br />Contact person Jo1u~ Livingston Contact person <br />Title Partner Title <br />Address 1660 Highway 100 S, Suite 500 Address <br />City, state; ZIP St. Louis Parlc, MN 55416 City, state, ZIP <br />Phone (612) 272-1246 Phone <br />Fax (612) 395-5530 Fax <br />E-mail Livingston@cognoscente.biz E-mail <br />4. Reason for EA~3' preparation (check one) <br />EIS scoping Mandatory EAW Citizen petition RGU discretion <br />X Proposer volunteered <br />If EAW or EIS is mandatory give EQB rule category subpart number IAA and subpart name <br />5. Project location County Ramsey City/Township Roseville <br />'/4 '/4 Section Township Range <br />Legal Description: <br />Lots Four(4), Five (5), Sixteen (16) and Seventeen (17), Block B, Ti>>in ]~riei~~ all according to the plat <br />thereof on file and of record in the office of the Register of Deeds in and for Ramsey County, 1linnesota, <br />subject to easements of record. (Tax parcel ~) 0~-029-23-33-0002 <br />Attach each of the follo~vinb to the EAW: <br />® County map showing the genera] location of the project; Prey-iously pro~lided City staff. <br />® U.S. Geo]ogical Survey 7.5 minute, 1:24,000 scale map indicating project boundaries <br />(photocopy acceptable); Previously provided City staff. <br />Site plan showing all significant project and natural features. Previously submitted to City staff. <br />6. Description <br />a. Provide a project summary of 50 words or less to be published in the EOB Monitor°. <br />Develop a 120 extended stay hotel and a S, 000 square foot high quality -eat in restaurant on a site <br />used for empty t~~ailer storage. The development ~~}ill result in a reduction of t1~e i»~zpervious sup face. <br />b. Give a complete description of the proposed project anal related new construction. Attach additional <br />sheets as necessary. Emphasize construction, operation methods and features that will cause physical <br />manipulation of the envirornnent or will produce wastes. Include modifications to existing equipment or <br />industrial processes and significant demolition, removal or remodeling of existing structures. Indicate <br />the timing and duration of construction activities. <br />