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18. ADDITIONAL.INFORMATION REQUIRED FOR PROJECT-SPECIFIC REPLACEMENT(Required only if you marked Box B or Box C in Section 14): For projects involving at least some project-specific replacement,include the following additional information: ❑Two drawings to scale of the replacement wetland. Include both overhead view and profile(side view or cross-sectional view). See What to Include on Plaits (Instructions,Page 3)for a detailed description of what should be included in these drawings. Without drawings,your application will be considered incomplete. ❑For created replacement wetlands,include additional soils information(if available)that indicates the capability of the site to produce and maintain wetland ' characteristics. Note 1: For replacement wetlands located on pipeline easements,you need to receive endorsement of your project from both the easement holder and the Minnesota Department of Public Safety's Office of Pipeline Safety. Before start of construction,the owner of any utilities must be notified. The landowner or contractor is responsible for giving this notice by calling"Gopher State Onc-Call"at 652-454-0002(Twin Cities Metro Area)or 1-800-252-1166(all other locations). Note 2: For extensive or complex projects supplementary information may be requested at a later dated from one or more of the responding agencies. Such information may include(but not be limited to)the following: topographic map,water table map,soil borings,depth soundings,aerial photographs, ' environmental assessment and/or engineering reports. 19. SIGNED AFFIRMATION: FOR PROJECTS INVOLVING REPLACEMENT BV WETLAND BANKING ONLY. To the best of my knowledge and belief;all information in Part II is true, complete and accurate;and I affirm that the wetland losses will be replaced via withdrawal from an account in the State Wetland Bank. FOR PROJECTS INVOLVING ETPHER PROJECT-SPECIFIC REPLACEMENT ONLY OR A COMBINATION OF NVETLAND BANKING AND PROJECT-SPECIFIC REPLACEMENT: Part A: The replacement wetland. 1 affirm that the replacement wetland was not: Previously restored or created under a prior approved replacement plan or permit;AND Drained or filled under an exemption during the previous 10 years;AND Restored with financial assistance from public conservation programs;AND Restored using private funds,other than landowner funds,unless the funds are paid back with interest to the individual or organization that funded the restoration;and ' the individual or organization notifies the local goverment unit in writing that the restored wetland may be considered for replacement. Part B: Additional assurances(check all that apply): ®The wetland will be replaced before or concurrent with the actual draining or filling of a wetland. ❑An irrevocable bank letter of credit,performance bond,or other acceptable security has been provided to guarantee successful completion of the wetland replacement. ®The wetland losses will be replaced via withdrawal from an account in the State Wetland Bank. Part C. For projects involving any project-specific replacement: Within 30 days of either receiving approval of this application or beginning work on the project,I will record the Declaration of Restrictions and Covenants on the deed for the property on which the replacement wetland(s)will be located;and 1 will at the same time submit proof of such recording to the LOU. To the best of my knowledge and belief,all information in Part II is true,complete and accurate;and I affirm all statements in Part A and C,as well as checked assurance(s)in Part B. II�IL'�l2 Signature or appl cant or a ent Dote ' FOR LGU USE ONLY Replacement plan is(check one): ❑Approved [JApproved with conditions(conditions allaciled) ❑Denied LGUofcial signature Date I,GU has reeeive evidence of title and proof of recording of Declaration of Restrictions and Covenants for Replacement Wetland: Count),where recorded Date Document 0 assigned by recorder LGU official signature Date Minnesota Local/State/Federal Application Forms for Watcr/Wetland Projects Page 6