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PLEI :OMPLETE THE FOLLOWING QUESTIONS BY G ';US <br /> ANY CurAMENTS OR SUGGESTIONS FOR HOW WE CAN L,. .OVE. <br /> Please Indicate the nature of your business flf applicable check more than one): <br /> _ Property developer _ FloodANater Control District — Sand & Gravel <br /> _ Public Agency Applicant — Consultant — Law Office <br /> _ Civic or Trade Organization _ Farming/Ranching — Silviculture <br /> _ Member of Legislature — Public Agency — Mining <br /> _ FederallState/Local Oficial _ PersonaUPrivate Project — Media <br /> _ Conservation Organization _ Adjacent Property Owner — Native American <br /> — Other(describe): <br /> What Service(s)Did You Seek From the Corps? flf applicable check more than one) <br /> — _ <br /> Junsdictionallwetland determination <br /> General Information <br /> _ Resolution of violationlnont mpliance <br /> Pre-application Consultation Regulatory Program presentaflon <br /> Nationwide general permit <br /> _ Regional or programmatic general permit _ Commented on Public Notice/permit application <br /> — Standard Individual permit — Other(describe): <br /> Letter of Permission <br /> Which Corps office(D/strfc;Division,Headquarters,other)did you deal with? <br /> Name of person you contacted in our office(optional): <br /> Do you have any comments or suggestions on the Regulatory Program? <br /> Information about you(optional): <br /> Namerritle: <br /> Address: <br /> Telephone (include area code): <br /> May we contact you? YES _ NO _ <br /> Authorities: The government Performance and Results Act of 1993 and Executive Order(EO)12862,"Setting Customer Service Standards",dated <br /> September 11,1993. Purpose: To determine the quality of services our customers expect,as well as their satisfaction with USACE's existing <br /> services. Information provided on this form will be used in evaluating the performance of the Corps Regulatory Program. Routine Uses: This <br /> infornation may be shared with the Office of Management and Budget,members of Congress,and other federal,state,and local government <br /> agencies. Disclosure: Providing requested information is voluntary. Failure to provide this information will not result in an adverse action. <br /> (Reverse of Eng Form 5065) <br />