Stormwater- Affiliates

Facility Name: ELLSWORTH NEIGHBORHOOD ADDITION - PHASE I - CONSTRUCTION

Permit Type: GP #2 Legal Status: Private     File No: 29536   Authorization No: 29536-29290

Expiration Date: 1/1/2019 (discontinued) Address: 110 ROCKSYLVANIA AVE. - IOWA FALLS , IA 50126

County: HARDIN Field Office: 2 SIC: Geospatial Information: 478882(X)/4708138(Y) (Electronic app)

Affiliates   Name Address City State Zip Phone Type LANCE SHARAR     IA     Certifier ELLSWORTH NEIGHBORHOOD INVESTMENT GROUP, LLC 1205 N. OAK ST. IOWA FALLS IA 50126 (641)648-5464 Owner LANCE SHARAR 1205 N. OAK ST. IOWA FALLS IA 50126 (641)648-5464 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