Benedictine Application and Plans.pdf

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5. RICE CREEK WATERSHED DISTRICT PERMIT APPLICATION Ira P C W D For Office Use Only h` ri RICE CREEK WATERSHED DISTRICT Permit App.#: 4325 Pheasant Ridge Drive #611 I Blaine, MN 55449 Date Received: Phone (763)398-3070 I Fax (763) 398-3088 Amount/Payer: Check Number: Permit Application Form Project Information Project Name: BHS Innsbruck Senior Housing Project Location: 1101 Black Oak Drive City or Township: New Brighton County: Ramsey Quarter: SW 1/4 Section: 19 Township: 30 N Range: 23 W Project Purpose: Building expansion for independent living,memory care and skilled nursing;reconfigured and additional surface parking. Area of Land Disturbance: 4.40 acres Aea of New and/or Reconstructed Impervious Surface: 3.53 acres Contact Information (All contacts will receive permit status updates) Applicant/Landowner(must be landowner or easement holder of record,and must sign application on reverse): Name: Benedictine Care Centers Address: 1101 Black Oak Drive Phone: (651)633-1686 Fax: (651)633-5267 City: New Brighton Email: andy.opsahl@bhshealth.org State: MN Zip: 55112 Official Representative(do not complete if same as above): Name: Address: Company: Phone: City: Fax: State: Zip: Email: Permitting Contact(developer, engineer, architect, wetland consultant, etc.): Name: David Yanik,Developer Authorized Agent? Yes © No o Address: 4400 Shoreline Drive Company: Yanik Companies Phone: (952)471-9199 City: Spring Park Fax: (952)471-9196 State: MN Zip: 55384 Email: davidyanik@yanikcompanies.com Permitting Contact(developer, engineer, architect, wetland consultant, etc.): Name: Mike Kettler,Civil Engineer Authorized Agent? Yes o No o Address: 10830 Nesbitt Avenue S Company: Sunde Engineering Phone: (952)881-3344 City: Bloomington Fax: (952)881-1913 State: MN Zip: 55437 Email: mkettler@sundecivil.com Submittal Requirements Applications submitted to the District must be complete and contain all required materials for each applicable District Rule. See the District's website for additional guidance and complete rules. RCWD will communicate an incomplete application status to the applicant,and no further action will be taken until additional submittals are received. Applicant must submit one(1)full sized copy(a readable ii"x 17" is acceptable)and either one(i) reduced size copy or an electronic copy of all required information. Projects involving a Wetland Replacement Plan have special noticing requirements,and require the submittal of four(4)copies of all wetland-related submittal materials. Permit applications involving wetland noticing must be submitted a minimum 5o calendar days prior to a regular Board meeting;permit applications not involving wetland noticing must be submitted a minimum 4o calendar days prior to a regular Board meeting. FEBRUARY 14,2020 LAND USE APPLICATION: 1101 BLACK OAK DRIVE, NEW BRIGHTON, MN 55112 23