Laserfiche WebLink
7. Does the MS4 have a process to evaluate discha may adversely affect <br />properties listed or eligible for listing in the National Register of Historic Places or <br />affecting known or discovered archeological sites? Sze Part IX of the Guidance Manual <br />for Small Municipal Separate Stalin Sewer Systems (1IS4s) for further information. <br />If you answered "No" to Item 5, 6, or 7, briefly explain how the MS4 will come into compliance with the <br />requirements of Appendix C. <br />©Yes EINo <br />This person must be duly authorized to sign the application (rnctyor, designated public works director, presider: <br />of the university, etc). <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, or <br />those persons directly responsible for gathering the information, the information submitted is, to the best of my <br />Icnowledge and belief, taste, accurate, and complete (Minn. R. 7001.0070). I am aware that there are significant <br />penalties for submitting false infonnation, including the possibility of fine and imprisonment (Minn. R. <br />7001 .0540). <br />Authorized Signature Dare <br />Schroeder <br />Greg Public Works Director <br />Last Name First Name <br />Official notices will be sent to person indicated here. <br />515 Little Canada Road <br />Title <br />Mailing Address <br />Little Canada <br />MN 55117 <br />City State Zip Code <br />651. 766.4049 greg.schroeder@ci.little-canada.mn.us <br />Telephone (include area code) E -Mail Address <br />.II'C.', M54 tornt Li I ern tlr.A up] icanon <br />„r,t :.24 - <br />'13/1 0iO4 <br />