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Brainerd: U.S. COE, Regulatory Branch 10867 E. Gull Lake Drive N.W. Brainerd, MN 56401-9051 Phone:218-829-8402 T~vo Harbors: U.S. COE, Regulatory Branch l 554 Highway 2, Suite 2 Two Harbors, MN 556]6 Phone: 218-834-6630 WEB SITES: BWSR: www.bwsr.state.mn.us U.S. ACOE: www.mvp.usace.army.mil DNR: www.dnrstate.mn.us MPCA: www.pca.state.mn.us NA-026620-038 (V.2.02 for MS WORD) 09/01/04 Minnesota Local/State/Federal Application Form for Water/Wetland Projects For Internal Use Only Application No. Field Office Code Date Initial Application Received Date initial Application Deemed Complete PART I: BASIC APPLICATION "See HELP" directs you to important additional information and assistance in Instructions, Page i. I. LANDOWNER/APPLICANT CONTACT INFORMATION (See Help 1) Name: Jerry Auge, Assistant City Engineer for Shoreview, MN Phone: 651-490-4659 Complete mailing address: City of Shoreview, 4600 Victoria Street North, Shoreview, MN 55126 St. Paul: U.S. COE, Regulatory Branch Army Corps of Engineers Centre 190 5'~ Street East St. Paul, MN 55101-9051 Phone:651-290-5375 La Crescent: U.S. COE, Regulatory Branch 1114 South Oak Street. La Crescent, MN 55947-1338 Phone:507-895-8059 lA. AUTHORIZED AGENT (See Help IA) (Only if applicable; an agent is trot required) Name: Beth Kunkel Complete mailing address: URS 700 Third Street South, Minneapolis, MN 55415 Phone: 612-373-6461 2. NAME, TYPE AND SIZE OF PUBLIC WATERS or WETLANDS IMPACTED (Attach Additional Project Area sheets if needed) Name or LD. # of Waters Impacted (if applicable; if known): Common Ponds (63W) (Check all that apply): Lake River etlan type I IL 2 3~4 5 6 7 8 Indicate size of entire lake or wetland (check one): Less than 10 acres (indicate size: 2.67 Ac) 10 to 40 acres Greater than 40 acres 3. PROJECT LOCATION (Information cati be found on property tax statement, property title or title insurance): Project street address: Fire #: City (if applicable): Shoreview '/a Section: SE Section: 14 Township #: 30N Range #: 23W County: Ramsey Lot #: Block: Subdivision: Watershed (name or #) Attach a simple site locator map. If needed, include on the map written directions to the site from a known location or landmark, and provide distances from known locations. Label the sheet SITE LOCATOR MAP. 4. TYPE OF PROJECT: Describe the type of proposed work. Attach TYPE OF PROJECT sheet if needed SEE gTr'ACKEp 5. PROJECT PURPOSE, DESCRIPTION AND DIMENSIONS: Describe what you plan to do and why it is needed, how you plan to construct the project with dimensions (length, width, depth), area of impact, and when you propose to construct the project. This is the most important part of your application. See HELP 5 before completing this section; see What To Include on Plans (Instructions, page I). Attach PROJECT DESCRIPTION sheet. -5 EE A-~q ct{E¢ Footprint of project: 0.96 acres or square feet drained, filled or cavate =e ~~7 ~`"^• ~~~ .? ~~: 6. PROJECT ALTERNATIVES: What altematives to this proposed project have you considered that would avoid or~~. minimize impacts to wetlands or waters? List at least TWO additional alternatives to your project in Section 5 that av __„ ~~{~ ~R wetlands (one of which may be "no build" or "do nothing"), and explain why you chose to pursue the option described ~~;this ~' f.~~ a lication over these alternatives. Attach PROJECT ALTERNATIVES sheet if needed. ~ ~~``~~`=="-~• SEE' A if w3 ~ J~iC;"`art 4fF5?> , 7. ADJOINING PROPERTY OWNERS: For projects that impact more than 10,000 square feet of water or wetlands, hs~t!~,, 7 r<'i`< complete mailing addresses of adjacent property owners on an attached separate sheet. (See HELP 7) - 4`;_~~.*.-~' SEE A'tr'gC~IE~ 8. PORTION OF WORK COMPLETED: Is any portion of the work. in wetland or water areas already completed? Yes to If yes, describe the completed work on a separate sheet of paper labeled WORK ALREADY COMPLETED. (See HELP 8)