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City of Mounds View <br />2401 Mounds View Blvd, Mounds View, MN 55112 <br />Phone: 763-717-4000 <br />Permit Application Form <br />Project Name: <br />Project Location: <br />City or Township: <br />Quarter: <br />Project Purpose: <br />Section: <br />I For Office Use Only I <br />Permit App. #: <br />Date Received: <br />Amount/Payer: <br />ICheck Number: I <br />County: <br />Township <br />Range: <br />Area of New and/or Reconstructed Impervious <br />Area of Land Disturbance (acres): Surface (acres): <br />Applicant/Landowner (must be landowner or easement holder of record, and must sign application on <br />Name: <br />Address: Phone: <br />Email: <br />City: <br />State: Zip: <br />Official Representative (do not complete if same as above): <br />Name: <br />Address: Company: <br />Phone: <br />City: Email: <br />M <br />Permitting Contact (developer, engineer, architect, wetland consultant, etc.): <br />Name: Authorized Agent? <br />Address: Company: <br />Phone: <br />City: Email: <br />State: <br />Zip: <br />Permitting Contact (developer, engineer, architect, wetland consultant, etc.): <br />Name: Authorized Agent? <br />Address: Company: <br />Phone: <br />City: Email: <br />State: Zip: <br />Yes <br />Yes <br />No <br />No <br />Submittal Requirements <br />Applications submitted to the City must be complete and contain all required materials for each applicable Rule. See the <br />Rice Creek Watershed District website for additional guidance and complete rules. The City will communicate an <br />incomplete application status to the applicant, and no further action will be taken until additional submittals are received. <br />Applicant must submit one (1) full sized copy (a readable 11" x 17" is acceptable) and either one (1) reduced size copy <br />or an electronic copy of all required information. Projects involving a Wetland Replacement Plan have special noticing <br />requirements and require the submittal of four (4) copies of all wetland -related submittal materials. Permit applications <br />involving wetland noticing must be submitted a minimum 50 calendar days prior to a regular City Council meeting; <br />permit applications not involving wetland noticing must be submitted a minimum 40 calendar days prior to a regular City <br />Council meeting. <br />1 City of Mounds View Stormwater Permit Application <br />