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Project Name and/or IYumber: 2d9Q Shoreline Drive,Orono—AE 14446 <br /> PART FOUR: Aquatic Resource tmpact1 Summary <br /> If your proposed project invalves a direct or indirect impad tc an aquatic resourc�(wetland, lake,tributary, etc.} identffy each <br /> impact in the table below. lnclude atl anticipated impacts, inciuding those expected to bs temporary. Attach an averhead view <br /> map,aeriai photo, and/or drawing showing all of tfie aquatic resources in the proJect area and the loca#ion(s) of the praprssed <br /> impacts.Label each aquatic resource on the map with a refierence number or tetter and identify the impa�ts in the fallowing table. <br /> Type of trnpact Duration of CouMy,Ma�ar <br /> Aqustic Resource �uatic (�II,excavate, lmpect Overell Sirs of Extstlng Plane Watershed#. <br /> ID(as noted on �u�� drain,or Pennanent(P) Size of ImpactZ AquaNc �mmunity and Bank <br /> overhead view} ��land,lake, remove or Temporary Resource 3 �e�s��n 4 Servke Ares� <br /> tributary etc,) 1 Impact Mea <br /> vegetation) (Tj of ImpactAreas <br /> 11f lmpacts are temparary;emer the duratlon of Che Impacts in days next to the"7"'. Fo�examplQ,a project with a temporary access fill that <br /> would be removed after 220 days would be eniered"T(220�'. <br /> zlmpacts less tha�0.01 acre should be reported In square feet. Impacts 0.07.acre or greater shauld be reported as acres and rounded to the <br /> �earest 0.01 acre. Tributary impacts must be feported in linear feet af impaet aod an area of impact by Indicatlng flrst the linear feet of impact <br /> abng the flowiine of the str�am followed by the area impact in parerrtheses). For example,a project that impacts 50 feet of a stream that is 6 <br /> feet vWde would be reported as 50 ft(300 square feet). <br /> �This is generally only applicable if you are applyfng for a de minimis exempdon under MN Rules 8420.0420 Subp.8,otherwise enter"N/A". <br /> �Us�Wetland P/ants and PJant Commun/ty 7ypes of Mlnnesota and Wlsconsln 3'�Ed.as modffled In MN Rules 8420.0405 Subp.2. <br /> SRefer to MaJo�Wate�ed arid Bank Service Area maps!n MN Rules 8420.0522 Subp.7. <br /> ff any of the above iderrtified impacts have already otcurred,identify which impacts they are and the circumstances associated <br /> with each: <br /> PART F11/E: Applicant Signature <br /> ❑ Chetk here if you are requesting a are-a�nlication consultatian wi#h the Corps and LGU based on the information you have <br /> provided. Regulatory entities will nat initiate a formal application review i�this box is checked. <br /> By signature below,I attest that the infosmation in this appfication is camplete and accurate. I further attest that I possess the <br /> authority to undertake the work described herein. <br /> 5ignature: � �'1.�� � � Date: g� 1 i � ��j <br /> I hereby authorize Andenon Engineertr�of MN,LLC to act on my behalf as my agent in the processing a#this application and to <br /> furnish,upon request,supptemental infarmatiort in support of this application. <br /> �The term`7mpact"as used in this jair�t applicatlon form is a generic terr�us�ed for disciosur�e purposes to��tify <br /> acdvitfes that may requMe apprcwsl from one or more regulatory sgencies. For purpasas of thts form it is not meant to <br /> indlcate whether or not those acthritles may requlre mttigatian/replacemerrt. <br /> Minnesota interagency Water Resource Application form February 2014 Page 4 of 5 <br />