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NA-026620-03B <br />(V.2.02 for MS WORD) 9/17/2007 <br />Minnesota Local/State/Federal Application Form for Water/Wetland Projects <br />For Internal Use Only <br />Application No. Field Office Code Date Initial Application Received Date initial Application Deemed Complete <br />PAIN' I: BASIC APPLICATION <br />"See FIELP" directs you to important additional information and assistance in Instructions, Page 1. <br />1. LANDOWNER/APPLICANT CONTACT INFORMATION (See Help 1) <br />Natne: Ramsey County Public Wx -Terry Noonan Phone: 651-266-7160 E-mail: <br />terry.noonan@co.ramsey. mn.us <br />Complete mailing address: 1425 Paul Kirkwold Drive, Arden Hills, MN 55112 <br />IA. AUTHORIZED AGENT (See Help IA) (Only if applicable; an agent is not required) <br />Name: Phone: E-mail: <br />Complete mailing address: <br />2. NAME, TYPE AND SIZE OF PUBLIC WATERS or WETLANDS IMPACTED (Attach Additional Project Area sheets if needed) <br />Name or LD. # of Waters Impacted (if applicable; if known): 62-0056 <br />(Check all that apply): ®Lake ^ River ^ Circular 39 Wetland type: ^ 1, ^ 1L, ^ 2, ^ 3, ^ 4, ^ 5, ^ 6, ~ 7, ^ 8 <br />Wetland plant community types: ^ shallow open water, ^ deep marsh, ^ shallow marsh, ^ sedge meadow, ^ fresh meadow, <br />^ wet to wet-mesic prairie, ^ calcareous fen, ^ open bog or coniferous bog, ^shruh-can/alder thicket, <br />^ hardwood swamp or coniferous swamp, ^ floodplain forest, ^ seasonally flooded basin <br />Indicate size of entire lake or wetland (check one): ^ Less than 10 acres (indicate size: ) ^ 10 to 40 acres ®Greater than 40 acres <br />3. PROJECT LOCATION (Information can be found on property taz statement, property title or title insurance): <br />Project street address: 330 Owasso Blvd N <br />Shoreview <br />'/4 Section: SE Section: 36 Township #: 30 Range #: 23 <br />Lot #: Block: Subdivision: <br />Fire #: <br />City (if applicable): <br />County: Ramsey <br />Watershed (name or #) 20 UTM location: N 4987647.54E 491174.77 <br />Attach a simple site locator map. If needed, include on the map written directions to the site from a known location or landmark, and <br />provide distances from known locations. Label the sheet SITE LOCATOR MAP. <br />4. TYPE OF PROJECT: Describe the type of proposed work. Attach TYPE OF PROJECT sheet. if needed. <br />Public Boat Launch Repair <br />5. PROJECT PURPOSE, DESCRIPTION AND DIMENSIONS: Describe what you plan to do and why it is needed, how you plan to <br />construct the project with dimensions (length, width, depth), area of impact, and when you propose to construct the project. This is the <br />most important part of your application. See HELP 5 before completing this section; see What To Include on Plans (Instructions, <br />page 1). Attach PROJECT DESCRIPTION sheet. <br />See attached sheet PROJECT DESCRIPTION <br />Footprint of project: acres or 105 square feet drained, filled or excavated. <br />6. PROJECT ALTERNATIVES: What alternatives to this proposed project have you considered that would avoid or minimize impacts <br />to wetlands or waters? List at least TWO additional alternatives to your project in Section 5 that avoid wetlands (one of which may be "no <br />build" or "do nothing"), and explain why you chose to pursue the option described in this application over these alternatives. Attach <br />PROJECT ALTERNATIVES sheet if needed. <br />See attached sheet PROJECT ALTERNATIVES <br />7. ADJOINING PROPERTY OWNERS: For projects that impact more than 10,000 square feet of water or wetlands, list the complete <br />mailing addresses of adjacent property owners on an attached separate sheet. (See HELP 7) <br />8. PORTION OF WORK COMPLETED: Is any portion of the work in wetland or water areas already completed? ^ Yes ®No. If <br />yes, describe the completed work on a separate sheet of paper labeled WORK ALREADY COMPLETED. (See HELP 8) <br />9. STATUS OF OTHER APPROVALS: List any other permits, reviews or approvals related to this proposed project that are either pending or <br />have already been approved or denied on a separate attached sheet. See HELP 9. <br />10. I am applying for state and local authorization to conduct the work described in this application. I am familiar with the information <br />contained in this application. To the best of my knowledge and belief, all information in Part I is true, complete, and accurate. I possess <br />the authority to undertake the work described, or I am acting as the duly authorized agent of the applicant. <br />Signature applicant (Landowner) Date Signature of agent (if applicable) Date <br />This block must be signed by the person who desires to undertake the proposed activity and has the necessary property rights to do so. Tf only the Agent has signed, <br />please attach. a separate sheet signed by the landowner, giving necessary authorization to the Agent. <br />Lake Owasso Boat Ramp DNR Waters Permit Application -Submitted March 17, 2009 Page 1 of 10 <br />