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� , <br /> y . � <br /> � � N ILLINOIS ENVIRONMENTAL PROTECTION AGENCY �nput forms in Word format are available <br /> NOTICE OF INTENT by via emai�. <br /> FOR GENERAL PERMIT FOR DISCHARGES FROM marilvn.davenportCa)epa.state.il.us <br /> or by calling the Permit Section at <br /> SMALL MUNICIPAL SEPARATE STORM SEWER SYSTEMS 217/782-0610 <br /> (MS4s) See address for mailing on page 4 <br /> For Office Use Only—Permit No. ILR40 <br /> Part I. General Information <br /> 1. MS4 Operator Name: City of Decatur <br /> 2. MS4 Operator Mailing Address: <br /> Street- #1 Gary K. Anderson Plaza City-Decatur <br /> State- Illinois Zip Code- 62523 <br /> 3. Operator Type: City <br /> 4. Operator Status: Local <br /> 5. Name(s) of Governmental Entity(ies) in which MS4 is located: Decatur, Macon County <br /> 6. Area of land that drains to your MS4 (in square miles): 66 square miles <br /> 5. Latitude/Longitude at approximate geographical center of MS4 for which you are requesting <br /> authorization to discharge: <br /> Latitude: 39 50 43 Longitude: 88 57 10 <br /> DEG. MIN. SEC. DEG. MIN SEC. <br /> 8. Name(s) of known receiving waters: Attach additional sheets (Attachment 1) as necessary: <br /> l. Sangamon River 2. Stevens Creek <br /> 3. Spring Creek(North) 4. Sand Creek <br /> 5. Spring Creek(South) 6. Big Creek <br /> 7. Finley Creek 8. <br /> 9. 10. <br /> 9. Persons Responsible for Implementation/Coordination of Storm Water Management Program: <br /> Name Title Telephone No. Area of Responsibility <br /> Stephen P.Swanson Director (217)424-2747 City Engineering and Infrastructure Department <br /> Phillip R.Wilhelm Manager (217)875-4820 Municipal Services <br /> Matthew C.Newell City (217)424-2747 City Engineering/Civil Site Review <br /> Engineer , <br /> Information required by this form must be provided to comply with 415 ILCS 5/39(2000). Failure to do so may prevent this form from being processed and could <br /> result in your application being denied. <br /> Page 1 <br />