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4. The two supplemental forms below, A-1 and A-2, will help the LGU ensure that the <br />landowner has good title. <br />Form A>1: Affidavit of Landowner(s) <br />This affidavit should be signed by the Landowner to affirm that he is the owner of <br />the property and that there are no mechanics' liens, judgments, delinquent taxes or other <br />encumbrances against the property. This affidavit should be notarized but it need not be filed <br />with the County Recorder. <br />Form A>2: Consent to Replacement Wetland <br />This consent form should be signed by ail parties who have an interest in the <br />Replacement Wetland (e.g., mortgagees, contract for deed vendors or vendees, licensees, lien <br />holders, owners of easements for a drainage system or utility (pipe)line which actually runs <br />through the Replacement Wetland). This consent form should be notarized and filed with the <br />County Recorder. <br />Form B:Declaration of Restrictions for Impacted Wetland Under <br />Agricultural Exemption <br />This form should be signed by a landowner who has obtained an exemption certificate from the <br />LGU under one of the Agricultural Exemptions of WCA (ex. #1,2,4,7,8 and 23). This <br />Declaration prevents the landowner from converting the land to non-agricultural use for 10 years <br />from the date of draining or filling, and also prevents the Impacted Wetland from being restored <br />for replacement credit for the same 10*year period. This form should be notarized and filed with <br />the County Recorder. <br />Form C:Declaration of Restriction for Impacted Wetland on <br />Agricultural Land in County or Watershed Containing Less <br />than 80% Presettlcment Wetlands <br />This form should be signed by the Landowner who has drained or filled a wetland on agricultural <br />land in a county or watershed containing less than 80% presettiement wetlands. The Declaration <br />prevents the Landowner from converting the land to non-agricultural use for 10 years from the <br />date of draining or filling, unless the Impacted Wetland is first replaced at the ratio for non- <br />agricultural land. <br />Biiminic.for (April, I99T) <br />: I