Stormwater- Affiliates

Facility Name: BROADLAWNS MEDICAL CENTER; EAST AND WEST SITE IMPROVEMENTS - CONSTRUCTION

Permit Type: GP #2 Legal Status: Private     File No: 27390   Authorization No: 27390-27254

Expiration Date: 8/1/2018 (discontinued) Address: 1801 HICKMAN RD. - DES MOINES , IA 50314

County: POLK Field Office: 5 SIC: Geospatial Information: 446349(X)/4607631(Y) (Electronic app)

Affiliates   Name Address City State Zip Phone Type JASON MATHES 4125 WESTOWN PARKWAY SUITE 100 WEST DES MOINES IA 50266 (515)223-8104 Contact BROADLAWNS MEDICAL CENTER 1801 HICKMAN RD. DES MOINES IA 50314 (641)755-2301 Owner JODY JENNER   DES MOINES IA 50314 (641)755-2301 Certifier Individual? Type:* --AFFILIATE TYPE-- OWNER OPERATOR CONTACT CERTIFIER Name: Title:   Company Name: C/O:   Address: Address 2: City/State/Zip   --Select-- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY PR OT E-mail:   Contact Owner   NO YES Preferred Method of contact EMAIL US MAIL Business Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Ext: Home Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Fax:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Mobile Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX