1995-04-27_AgendaPacket - Laserfiche WebLink

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NA-oz6zaol r LOCAL -STATE -FEDERAL WATER RESOURCE PROJECT NOTIFICATION /APPLICATION FORM Use this form to notifylapply to the U.S. Army Corps of Engineers, the Minnesote Department of Natural Resources, and your Local Government Unit of a proposed water/wetland project or work which may fall within their jurisdiction. These agencies should advise you of their jurisdiction or permit requirements within 45 days. Some LGU's may also require submission of their own application forms. Fill out this form completely and mail a copy, with plans, maps, etc. to each of the agencies listed on the reverse of the form. Keep a copy for your records. YOU MUST OBTAIN ALL REQUIRED ei ITUnR17ATI~NS BEFORE BEGINNING WORK. AGENCY USE ONLY: LGU NUMBER: DNR NUMBER: ~ ~~ CORPS NUMBER: I. Applicant's Name (Last, First, M.1.1 Authorized Agent, if any Area Code, Telephons ~AMSi;'( C~i,~i,rK t ~K-s ~ I~T-~ ~~Pt= GR~ A• Mac, = b~o~ (~)v ?7~-033 Address (Street, RFD, Box Number, City, State, Zlp Code) ~oiS YAN bKK~ S'fI~~F.LT 1J • MP.PL!/\VbO~ 1 MtJ SSId~ II. Location of proposed project (attach drawing showing how to get to site) COUNTY QUARTER SECTION(s- SECTIONS(s) No. TOWNSHIPlsi No. RANGE(sf No. Lot, Block, Subdivision P-AMS~'~ ~\v Yq Z`~ 3v 23 FIRE No., BOX No., OR PROJECT ADDRESS NAME OF WATERBODY AFFECTED and NUMBER (IF KNOWN) 51~P•~l. LA-~E ~(,IONAL Pp.~ r41°~I ga-A! Lyc, SNAIL 1_AK.E GZ.-73 III. ESTIMATED PROJECT COST: S 3t~00 LENGTH OF SHORE AFFECTED ((n feat): ~~Qt IV. VOLUME OF FILL OR EXCAVATION (Cubic Yards): INOTE.• You may substitute dimensions) AREA FILLED OR EXCAVATED IS t`p L.~(. Acres, OR Square Feet yi~N, ELAN 1~`r V. TYPE OF WORK AND AREA (CHECK ALL. THAT APPLY): ^ ACCESS PATH ^ BRIDGE ^,CULVERT ^ DAM ^ CONSTRUCT ^ DRAIN ^ EXCAVATE ^ DDCK ^ RIPRAP ~,SANDBLANKIT ^ FILL ^ REMOVE ^ REPAIR LAKE ^ SHORELINE ^ WATERWAY ^ WETLAND OTHER !DESCRIBE): WETLAND TYPE(St AND ACREAGES) PROPOSED TO BE FILLED/DRAINED: Attach applicable drawings, pans, end ASCS crop photos. Include a description of any proposed compensatory mitigation. Important: Identify any disposal and borrow areas. Describe the work below: how it would be done; what equipment would be used. pLP~ E•1~,~ of Sp.+r1b ~LANM-~ as SHo~UWE ANa LAKE &'rt'tbM ?o MalNiba~1 pND IrnPR-CIE 5l~/tMM-NG B~A41 la" LA~(EK- ~\JA(LD~q''-13'!.A`~ER- LP~1~£~JARD ~M ~VATEI~-UN~. . '$i~n1Y-e( fl.Dd•EC otJ ~'ZL1J L-~S[£ VI. PROJECT PURPOSE (why is this project needed--what benefits will it provide?!: SV~AC~ $~ DUMP"T'R~~-lG5 , S ~ aUu'~~~-• -tn (M~ovE ~D MA11~A~N lt.EA+~ SAa~Y C,~~~rtY of Pu~UL S~v~ca~~*+~ BEP•C~ ~-~ ~t(ab1.19•~. PAR-- L~M-~4 p~ENtl:•( NRS $f~1 1'~FAEVFa.l=PED- tea 5t4N-l=1Ct~T NEGATIY6'E1JY1~1n1(:N•'Cal~ tMPAcT'S VII. ALTERNATIVES (describe any other sites or methods that could be used to achieve the purpose of your project while avoiding or minimizing wetland/water impacts: Attach additional sheets, if needed!. 1Jp~.lE ~ -~XIST(f.>v SjwD BEACrI JWD SNoR~Lit~ j ~• OF S(,vtiM`M~~ BrraGA P-F,L=CATED"To ~WOi~- SITE OF $CAT P-AMP \vKI~F1 \vA5 dS0 R~LO!_AT~D -; SUITABIE~ SAND $PSE T(tlu-1~- IN ;F{IS t+,P-a:A) VIII. GATES: Proposed start of activity: FE~IZU~ 1S ~ (°» S Proposed completion: ~E~~j~Q=( Zp ~ ~°~°~rj ~j~.K.£W A~D~ ~~( i5, \~S ~I,.ba1D~Vb~D (Identify any completed work on an attached draw(ng) IX. ADJOINING PROPERTY OWNERS (Attach list if more than two) Name Address City State ZP _ ~L •Bu~YO`~ 733 M~~Y 1,4.-~ 5}IO~EYIEw MN 55124 X. PERMITS have been received (enter an R) or already applied for (enter an A) from: _ DNR _ ARMY CORPS OF ENGINEERS _ COUNTY A TOWN/CITY ~ WATERSHED DISTRICT _ MN POLLUTION CONTROL AGENCY Has an archaeological survey of the project site been done? WD If so, by whom: I hereby notify the recipients of this form of the project proposed herein and n this project that I must obtain. I understand that proceeding with work before and/or local administrative, yOlf~nd/or criminal penalties. of Pe n osing Project or Agent < < < PLEASE CAREFULLY READ AND any permits or other determinations concerninc pre obtained may subject me to Federsl, State ~~~~ v~'ir "• c cF >- tiFa ~,~ ,~+ t~LETC BUCK OF FQRM > > > h ~- r~~ - DATE: ` '~ ~ ~ ^ ~ r