Stormwater- Affiliates

Facility Name: KWIK STAR 3 165 - CEDAR RAPIDS - CONSTRUCTION

Permit Type: GP #2 Legal Status: Private     File No: 28601   Authorization No: 28601-28333

Expiration Date: 4/26/2017 (discontinued) Address: 3730 WILLIAMS BLVD. SW - CEDAR RAPIDS , IA 52404

County: LINN Field Office: 1 SIC: Geospatial Information: 605999(X)/4645332(Y) (Electronic app)

Affiliates   Name Address City State Zip Phone Type BRENT DUSEK     IA     Certifier KWIK TRIP, INC. 1626 OAK ST. LA CROSSE WI 54601 (608)793-5551 Owner BRENT DUSEK 1626 OAK ST. LA CROSSE WI 54601 (608)793-5551 Contact 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