Stormwater- Checklist

Facility Name: KOLLASCH - JACK CREEK SITE

Permit Type: GP #2 - Construction Activity Legal Status: Private     File No: 11727   Authorization No: 11727-11517

Expiration Date: 6/9/2008 (discontinued) Address: 5180 250TH STREET - RINGSTED , IA 50578

County: EMMET Field Office: 3 SIC: Geospatial Information: 373004(X)/4793557(Y)

Checklist Checklist Completed. Automatic Update NOI Received Fee Correct Facility Info PPP Developed Location Info PPP Comply Outfall Info Public Notice Received   Contact Info Public Notice Complete   Permit Type Info Signature   Fee Paid File Memo   Fee Memo