Stormwater- Checklist

Facility Name: KUM AND GO #542

Permit Type: GP #2 Legal Status: Private     File No: 25249   Authorization No: 25249-24997

Expiration Date: 5/1/2015 (discontinued) Address: 11989 HICKMAN RD. - URBANDALE , IA 50322

County: POLK Field Office: 5 SIC: Geospatial Information: 435036(X)/4607733(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