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Lower <br /> Rum River Permit# <br /> 1fflWM0 <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 Jon Fletcher Presbyterian Homes&Services and Senior Housing Partners <br /> Name of Applicant(Site Owner or Property Owner) Applicant's Contact Organization Name <br /> 14501 Nowthen Blvd 2823 Hamline Avenue N, <br /> Address Address <br /> Ramsey, MN Rosevi I le,MN 55113 <br /> CitYSs ,Zip City,State,Zip <br /> 651.383.5689 <br /> Phone Fax Phone Fax <br /> jfletcher@seniorpartners.com <br /> Email 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 /> ❑❑ REQUEST FOR NO LOSS OR EXEMPTION UNDER THE WETLAND CONSERVATION ACT(WCA) <br /> ❑❑ WETLAND REPLACEMENT PLAN AND/OR SEQUENCING <br /> [E] WETLAND BANKING PLAN <br /> ❑❑ OTHER <br /> Andover-Anoka -Ramsey• 2015 First Avenue *Anoka, MN 55303• www.lrrwmo.org/ <br /> C-1 <br />