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<br />RECEIVED 0 ell 8 1982
<br />
<br />R ,I \. ,'I{El':I-' WA'rf::t{SllED DIS'L'lHC'l'
<br />S'.! ";1-: l77, ARDlm PLAZA
<br />.;,5>:' j NORTH LEXINGTON AVENUE
<br />,'dJEN HIL.LS, MINNEsn'l'A 55112
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<br />RuJfY~~ ,
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<br />- ,,--,- -----rFor-Of"r[ce'-Us-e--OriYyr---.- --,-
<br />P ERMI'f APPLICATION NO. _B2:r~ \ z1...... '__
<br />Rec'a Office ~~~J~~2Rec'a Engr. ~~~~~
<br />Notice Sent ~IQ.:-~=~,~ __ . .----
<br />Agenda \() - ~! -S-"'L
<br />-,---- ------,-,-,-- ~,-'-1LL
<br />Administrative Fee ' .
<br />
<br />~---_.._. ~.-. -_. ----..--.------.-- - _.----
<br />
<br />PERMIT APPLIC~rION
<br />
<br />lJ, 13~
<br />
<br />!~.b~~ompleted by the applicant
<br />
<br />
<br />Date: Octobecll-.l982
<br />lephone No.: 633-1533
<br />.- ~~~
<br />
<br />~gnature of Owner or
<br />
<br />)wner: City of !I=~ B~!ghton______._,_
<br />l\ddress:
<br />
<br />C it y : ~w B ~J:J51.! t:.o_Il-' MN
<br />
<br />55112
<br />(zIp' coder
<br />
<br />
<br />~If,/L .,. JJ.
<br />A9~
<br />
<br />803 Fifth Avenue N.W.
<br />
<br />Permit Application for Approval 0
<br />
<br />:lJ9o-Ini?rehensi ve Stormwater
<br />Management Plan
<br />~Xg' , Land Development Plan
<br />:x . Final Site Drainage Plan
<br />. Use and/or Appropriation
<br />of Public Waters
<br />r Bridge and/or culv~rt Construction
<br />Wetland Alteration
<br />Shoreland (Riparian) Improvement
<br />Private Drainage System
<br />Individual Sewage Treatment System
<br />Other (e xptain in rema r'<s )
<br />
<br />Remarks:
<br />
<br />~.;u::e of Pre ject:
<br />
<br />New Brig~~o~ Medical Center
<br />
<br />lrpose of project:_ O~!_ic~_-Bui1ding Construction
<br />
<br />~,:)~ation of Project-Addr(~3S: N.W. Quadrant, Fifth Avenu:e aI!d Tenth Street
<br />
<br />Ynnicipality or Township: ,__~e", Brighton
<br />
<br />S.E.
<br />
<br />l/4 of Sect 1.(;,
<br />
<br />20
<br />
<br />Township
<br />
<br />30N
<br />
<br />Range
<br />
<br />23W
<br />
<br />;:all 483-0634 if assis::ance in completing this forn; is required. Please
<br />attach drawings, plans and other data as outlined in "Rice Creek Watershed
<br />District Permit Infornation Brochure, available upon request. Mail or
<br />deliver t ~s form alon~ with a $10.00 administrative fee and appropriate
<br />,~xhibi ts to the ab "':ve .address.
<br />
<br />,';t\ fi eld inspec tion f€ )H r_'--ds permit shall be coo. ('ged to cover actu ' : s
<br />'~lated to <'\ fie '..d:'1sp .c-tiOfl including the investi.:Jati'>o of the are0
<br />It'E~~ted by the pr-Cjoo~e -",." i\lity, analysis of the proposed activity.
<br />r.; ;?rvices of a consul t:,C\nt an0 1.n addition, a fee will be charged fc ,)."
<br />';:~quired subseq:uent ~,' ,rt::>rin(j of the proposen activity." M.S.A. llr.
<br />~ 'hd. 2. Applyinr' < ,- t:-, s. permit to RCWD does d()t preclude your ap!
<br />~",r any necessa.... p' ,d. t may be required frnrn o_,:.!:.",,:government,} I
<br />,enct.es.
<br />
<br />Rev:.::- eC', 2/2/81
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