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Project Name and/or Number: 79Q Bro���n Ro�d North <br /> PART FOUR: Aquatic Resource Impactl Summary <br /> If your proposed project invoives a direct or indirect impact to an aquatic resource (wetland, lake, tributary, etc.j identify each <br /> impact in the table below. Intlude ail anticipated impacts, lntluding those expected to be temporary. Attach an overhead view <br /> map, aerial photo, and/or drawing showing all of#he aquatit resources in the project area and the location{s) of the proposed <br /> impacts. Label each aquatic resource an the map with a reference number or letter and identify the impacts in the foAow(ng table. <br /> Aquatfc Aquatic TYpe of Duratfon of Qverall Sfze County,MaJor <br /> Resource ID Resource T e �ml�act(fifl, Sfze of Watershed#, <br /> yp excavate,drafn or �mpact �m act� of Aquatic �xisting Piant Community <br /> (as noted on (wetland,lake, ' Permanent(Pj or p Resourte 3 Type(5)in Impact Area'4 and Bank <br /> overhead view) tributary etc.} �emove 7em ora 7' �59uare feet) SefV1Ce AYea ti <br /> vegetatlon} p �{ � (square feet) <br /> of Impact Areas <br /> Wetland 1 Wetland NA NA NA 30,988 $Ottou�l��id forest/sl�ailo�v <br /> �narsl� Hennepin Co. <br /> Mississippi <br /> River Metro <br /> 20) <br /> Bank Service <br /> Total Are3 7 <br /> 30,988 <br /> lif impacts are temporary;enter the duration of ti�e impacts in days next to the"T", For example,a proJect with a temporary access fill that <br /> would be removed aRer 220 days woufd be entered"T(220)". <br /> zlmpacts less tlian 0.01 acre shouid be reported in square feet. Impacts 0.01 acre or greater should be reported as acres and rounded to the <br /> nearest 0.01 acre. Tributary fmpacts must be reported in linear feet of Impact and an erea of impact by indlcatfng first the linear feet o#impacE <br /> along the flowline of the stream fallowed by the area impact in parentheses}. For example,a pro)ect that impacts 50 feet of a stream that ls 6 <br /> feet wide wou�d be reported as 50 ft 5300 square feet). <br /> 3This is generally only applicab(e if you are applying for a de minimis exemptfon under MN Rules 8420.0420 Subp.8,otherwise enter"fV/A". <br /> 'Use Wetland Plpnts ond Plpnt Community Types of Mlnnesota or►d Wisconsfn 3`d Ed.as modified ln MN Rules 8420.0405 Subp.2, <br /> SRefer to Major Watershed and Bank Servfce Area maps in MN Ru1es 8420.OS22 Subp.7. <br /> 1f any of#he above identified impacts have already occurred,identify which impacts they are and the circumstances associated <br /> wlth each: <br /> PART FIV�: Applicant Signature <br /> ❑ Check here if you are requesting a pCe-applicat(on consultation with the Corps and LGU based on the information you have <br /> provided. Regulatory entities wili not initiate a formal application review If this box is checked, <br /> By signature below, I attest that the information in this application fs compiete and accurate. i(urther attest that I possess the <br /> authority to undertake the work described herein. <br /> 5ignature: � � S <br /> Date: � • <br /> I hereby auth iz Kjolhaug E� iroumeutal Services to act on my behalf as my agent in the processing of this applica#ion and to <br /> furnish, upon re est,supplemental information in support of this applicatlon. <br /> 1 The term"Impact"as used in thls jotnt applicatlon form is a generlc term used for dlsciosure purposes to Identify <br /> activities that may requlre approval from one or more regulatory agencies. For purposes of this form it is not meant to <br /> indicate whether or not those activitles may requfre mltfgatlon/replacement. <br /> Minnesota Interagency Water Resource Appllcation Form February 2014 Page 2 of 3 <br />