Stormwater- Affiliates

Facility Name: LAUNCH TOWNHOMES AT KETTLESTONE - CONSTRUCTION

Permit Type: GP #2 Legal Status: Private     File No: 42196   Authorization No: 42196-41823

Expiration Date: 11/22/2026(current) Address: 2920-2980 SE LA GRANT PKWY AND 3207 SE ASHWORTH ROAD - WAUKEE , IA 50263

County: DALLAS Field Office: 5 SIC: Geospatial Information: 427872(X)/4603348(Y) (Electronic app)

Affiliates   Name Address City State Zip Phone Type NICHOLAS JENSEN     IA     Certifier 31495 ASHWORTH ROAD, LLC 1680 SW ANKENY ROAD, SUITE 1B ANKENY IA 50023 (515)290-9359 Owner NICK JENSEN 1680 SW ANKENY ROAD, SUITE 1B ANKENY IA 50023 (515)290-9359 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