Appl/activites affecting water resources

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Project Name and/or Number: Attachment E Local Road Replacement Program Qualification Complete this part If you are a local road authority(county highway department,city transportation department,etc.)seeking verification that your project(or a portion of your project)qualifies for the MN Local Government Road Wetland Replacement Program(LGRWRP). If portions of your project are not eligible for the LGRWRP,then Attachment D should be completed and attached to your application. Discuss how your project is a repair,rehabilitation,reconstruction,or replacement of a currently serviceable road to meet state/federal design or safety standards/requirements.Applicants should identify the specific road deficiencies and how the project will rectify them.Attach supporting documents and Information as applicable: Provide a map,plan,and/or aerial photograph accurately depicting wetland boundaries within the project area.Attach associated delineation/determination report or otherwise explain the method(s)used to identify and delineate wetlands.Also attach and discuss any type of review or approval of wetland boundaries or other aspects of the project by a member or members of the local Technical Evaluation Panel(TEP)or Corps of Engineers: In the table below,identify only the wetland impacts from Part 4 that the road authority has determined should qualify for the LGRWRP. Wetland Impact ID Type of Impact Size of Impact County,Major Watershed#, as noted on Existing Plant Community ( (fill,excavate, (square feet or 1 and Bank Service Area#of overhead view) drain) acres to 0.01) Type(s)in Impact Area Impact2 lUse Wetland Plants and Plant Community Types of Minnesota and Wisconsin 3`d Ed.as modified in MN Rules 8420.0405 Subp.2. 2Refer to Major Watershed and Bank Service Area maps In MN Rules 8420.0522 Subp.7. Discuss the feasibility of providing onsite compensatory mitigation/replacement for important site-specific wetland functions: Please note that under the MN Wetland Conservation Act,projects with less than 10,000 square feet of wetland impact are allowed to commence prior to submission of this notification so long as the notification is submitted within 30 days of the Impact. The Clean Water Act has no such provision and requires that permits be obtained prior to any regulated discharges Into water of the United States. To avoid potential unauthorized activities,road authorities must,at a minimum,provide a complete application to the Corps and receive a permit prior to commencing work. By signature below,the road authority attests that they have followed the process In MN Rules 8420.0544 and have determined that the wetland impacts identified in Attachment D are eligible for the MN Local Government Road Wetland Replacement Program. Road Authority Representative: Title: Signature: Date: Minnesota Interagency Water Resource Application Form February 2014 Page 10 of 11