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Lower <br />�I111 � Rum <br />River <br />Permit # <br />APPLICATION FOR MINNESOTA WETLAND CONSERVATION ACT <br />(WCA) DECISIONS AND PROCEDURE REQUIREMENTS <br />A $75.00 LRRWMO initial application fee and the appropriate escrow deposits (determined in accordance with <br />Attachment W3) must accompany this permit application for any Wetland Conservation Act (WCA) decisions. <br />These are separate and in addition to permit and escrow fees for Grading, Stormwater Management, and <br />Erosion/Sediment Control permit application, if applicable. <br />Permits are to be processed at the same time as the site plan, preliminary plat or other city land use or building <br />application submitted to the city in which the work or project is located. <br />Wetland permit processing takes longer than other permit processing. The permit application and supporting <br />documentation should be submitted to the LRRWMO AT LEAST 60 DAYS PRIOR TO THE REGULARLY SCHEDULED <br />MONTHLY LRRWMO MEETING AT WHICH A DECISION IS REQUESTED. A PERMIT NUMBER WILL NOT BE ASSIGNED <br />UNTIL CITY AUTHORIZATION IS RECEIVED. <br />Project Name: Presbyterian Homes & Services and Senior Housing Partners/Lord of Life Lutheran Church <br />Address/Location: 14501 Nowthen Blvd. NW, Ramsey, Anoka County, Minnesota <br />Project Description/Purpose: Potential grounds improvement project. <br />Lord of Life Lutheran Church <br />Name of Applicant (Site Owner or Property Owner) <br />14501 Nowthen Blvd <br />Address <br />Ramsey, MN <br />CitYSs, Zip <br />Phone Fax <br />Email <br />Jon Fletcher Presbyterian Homes & Services and Senior Housing Partners <br />Applicant's Contact Organization Name <br />2823 Hamline Avenue N, <br />Address <br />Rosevi I le, MN 55113 <br />City, State, Zip <br />651.383.5689 <br />Phone Fax <br />jfletcher@seniorpartners.com <br />Email <br />Submittal Requirements <br />Complete applications are to be submitted as per LRRWMO attachments W1 (Permit Requirements), W2 (Office <br />Procedure), and W3 (Fees, Deposit, and Sureties for Wetland Conservation Act) included with this application. <br />Projects may also require a LRRWMO Grading, Stormwater Management, and Erosion/Sediment Control Permit <br />(separate application and fee/escrow amounts) <br />PROJECT SUBMITTALS (check all that apply): <br />❑� WETLAND BOUNDARY DELINEATION AND TYPE CONCURRENCE <br />[E-1] REQUEST FOR NO LOSS OR EXEMPTION UNDER THE WETLAND CONSERVATION ACT (WCA) <br />[E-1] WETLAND REPLACEMENT PLAN AND/OR SEQUENCING <br />[E-1] WETLAND BANKING PLAN <br />❑❑ OTHER <br />Andover - Anoka - Ramsey • 2015 First Avenue * Anoka, MN 55303 • www.lrrwmo.org/ <br />C-1 <br />