2019.04.15 CC Packet - Laserfiche WebLink

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Project Name and/or Number: PART ONE: Applicant Information If applicant is an entity (company, government entity, partnership, etc.), an authorized contact person must be identified. If the applicant is using an agent (consultant, lawyer, or other third party) and has authorized them to act on their behalf, the agent's contact information must also be provided. Applicant/Landowner Name: Mr. Chris Stokka, Development Manager MWF Properties Mailing Address: 7645 Lyndale Avenue South Minneapolis, MN 55423 Phone: 612-243-4636 E-mail Address: ChrisStokka@mwfproperties.com Authorized Contact (do not complete if same as above): Mailing Address: Phone: E-mail Address: Agent Name: Kenneth Meek, PG, CPG Earth Science Associates, Inc. Mailing Address: 37445 Grand Avenue North Branch, 55056 Phone: 612-718-0413 E-mail Address: esa332@gmail.com PART TWO: Site Location Information County: Washington City/Township: Hugo Parcel ID and/or Address: 19.031.21.21.0013 Legal Description (Section, Township, Range): Sec.19, Twp. 31 N., Rng. 21 W. Lat/Long (decimal degrees): 46.103 N., 92.783 W. Attach a map showing the location of the site in relation to local streets, roads, highways. Approximate size of site (acres) or if a linear project, length (feet): 18.15 acres total. Approximately 3 acres of high ground in the south part would be developed. If you know that your proposal will require an individual Permit from the U.S. Army Corps of Engineers, you must provide the names and addresses of all property owners adjacent to the project site. This information may be provided by attaching a list to your application or by using block 25 of the Application for Department of the Army permit which can be obtained at: httr!//wv nvo.usace.armv.mil/l-. rtalslI 'regulatory/Regulatory_ _s/eneform 4345 2012oct.pdf Minnesota Interagency Water Resource Application Form February 2014 Page 3 of 16