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<br />R leE CRF:I:~I' ~\:'\'rl:':hS!jED DISTUCT <br />SUITE 177, ARDEN PLAZA <br />3585 NORTH LEXINGTON AVENUE <br />ARDEN HILLS, MINNESOTA 55112 <br /> <br />i ..' <br />I <br /> <br />'(For -offIce -\)5-e- -OnlYJ---' <br />PERMIT APPLICATION NO. <br />Rec I d Of f ice ______ Rec"(j--Engr:---_==-=== <br />Notice Sent <br />Agenda <br />Administrati veFee-----' <br /> <br />~~ <br />~(v-> I)~ <br />"}' IV.... <br /> <br />PERMIT APPLICATION <br /> <br />~_~~~_ completed by the applicant <br /> <br />Owner: City of New Br~gh~o~________ ' <br /> <br />Date: ~ctQ.beT-llJ982 <br /> <br />Address: 803 Fifth Avenue N.W. <br /> <br /> <br />lephone No.: <br /> <br />-~ <br /> <br />fgnature of <br /> <br /> <br />Ci ty: _~w Brij?;J:.1ton, MN 55112 <br />-rzrpcod el- <br /> <br />Permit Application for Approval 0 <br /> <br />Remarks: <br /> <br />o <br />~ <br /> <br />Comprehensive Stormwater <br />Management Plan <br />Land Development Plan <br />Final Site Drainage Plan <br />Use and/or Appropriation <br />of Public Waters <br />Bridge and/or Culvert Construction <br />Wetland Alteration <br />Shoreland (Riparian) Improvement <br />Private Drainage System <br />Individual Sewage Treatment System <br />Other (explain in remar~s) <br /> <br />,brne of Project: <br /> <br />New Brighton Medical Center <br /> <br />~urpose of Project: <br /> <br />Offic~uilding Construction <br /> <br />Location of Project-Address: N.W. Quadrant, Fifth Avenue and Tenth Street <br /> <br />Municipality or Township:_~ew Brighton <br /> <br />S.E. <br /> <br />1/4 of Sect ion <br /> <br />20 <br /> <br />Township <br /> <br />30N <br /> <br />Range <br /> <br />23W <br /> <br />Call 483-0634 if assistance in completing this form is required. Please <br />attach drawings, plans and other data as outlined in "Rice Creek Watershed <br />District Permit Infor~ation Brochure, available upon request. Mail or <br />deliver t1 ~s form along with a $10.00 administrative fee and appropriate <br />exhibits to the ab~ve address. <br /> <br />"A field inspection fE' , ':)n this permit shall be charged to cover actua - -,.- s <br />related to a field insp.~ction including the investigation of the area <br />affected by the propose~ activity, analysis of the proposed activity, <br />services of a consultant and in addition, a fee will be charged fer dr' <br />required subsequent ;r. n itoring of the propose(} activity." t-1.S.A. ll~. s. <br />Subd. 2. ApplyinC" fr,," tl1~,S permit to RCWD does not preclude your app:'-:, ,:19 <br />for any necessary pe" ,-,; ndt may be required from oth~r governmental <br />agencies. <br /> <br />'18--78 <br /> <br />Revi~ed 2/2'81 <br />