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, ' _ � 1 <br /> 18.ADDIT[O�ril,I�i'FpIii\l.LTIpN ItEQUIItEU FOR PRO,IECT SPECIElC ttEPLACE�i6\'T(Required ott{�•ilyau mnrkcd IIac B or Box Gin Section 14): <br /> For�rojccts ia��ot�iog at teut;omc prajcet ipecific mphtcement.inatud�Use faltoxdng addiGortal infomtation: <br /> . �TE•o dcarrtugs to scnte of Usc tep!¢cc3ttenl neEtmTd. lncfuds b�h o�trhead vic�v nnd profde(side��t��or cmu-seccioaat virnj. Scc Jf7rnr ro Inrlmk an Pioru <br /> (Instruetimu,Pegc 3j for adetatled description of��fiat 5lwuld be includzd in thcio cira���ings, Withput drmvings,;nnr applicetidn up[be eoasidcrcd taemnpktc. <br /> []For crcated rep2aeeaicnt cceUands,include addi;ianal soits infomiatian Cfavatlahte)that tadicates ilie capability ofihc site eo pro�uct and m�i�unin�rrtlaud <br /> charamrisG�, <br /> i�otc 1: For repl�cemeat i��ettands Tocstcd on pipetine easenunts,�+oci rtced to rccci��c cndorsnnci�i ofy�uurpmject tront bolh tfte euscatenthotdrrand thc MisutesMa <br /> Depurtu�entaf Pubiic SafNy's O(lict of Pipctine Safeiy. BcForosttsrt of.catstructton,the o�ti�ner ofnny ntititics mtat be notified_?ho(ando�crer ar canhactor is <br /> cesponsible for gisiag this naucs by.ceiling"Gopher Stale OnaCnU"ai 652-d54-40U2(T�ti9n Glties Metro Ares)or 1•800•232-I 16G(ait oqstrlocntians}, <br /> i�ote 2: For e�tcrtsi�^t or coniplez proJerts snpptrmentnry ipfomuliom m�y be requested at o Iater datcd fmm one or u�orc of.the tzspouding agencses, <br /> Such infosmatian may inciudc(buf not bc limitcd toj tIu fofla«ting; toPograAhia mnp,�rater tablc map,soil horings,dcp�h soundinss,ec�tal phWognphs, <br /> cnviroarnental assessnteitt and/ot engineering reports. <br /> 19. SIG\EDAFFIfi,tLtTIQ\: <br /> FOIt FRQJEC7'S 1�YOLYi\G REPLACE�EE�T I31'�YET'LAi\!I Brti\KI,�G Q\LY.To tha best ofmg luto�ticdge and 6clicf,a!I 1nComtatipn(n F�rt U is ttuc, <br /> comp[ete and accurate;and I aFTim►that tGe urttend tasses e�ll 6�rcpinred vi��vidcdrmt�nl fram au acrouitt in.the Statc i<<ctland 8nn1:. <br /> FOR PR03ECTS L�VOG�'1\G ETTHER.PR03EC1'-SFEC[FIC REPI.ACE,ltE1!'O\[.1'OR rl CO�ID4�A'I'[p\OF 1�'E!'L.A\'D:L3A\'Ki�'G <br /> .1\D PRQ7ECT SPECIFIC REf'L.ACE�[E\T: <br /> Part A: 'The replscemeut rrctlnnd. 1 aRinn thnt tht raplarcnunt ttetland���ns not: <br /> Pre��iausty ceseered�nr crcnted undcr a prior approred nplacemcnt plan o�pemtit;Ai�D <br /> Uraicted or fe!!ed under an e.�cmption during thc prerious!6�rars;A,tiQ . <br /> Restnrcd��yth financial assistnnce fron►pubHo eortservafion progrnrns;A�aD <br /> Restorrct usmg pri��n;e Cunds,other than landm�ner tunds,untess qie fu�uls nrz paid b.hcl:�Yi�h inEcrest to flie indtvidual ar organizati�thrit funded tua resloretion;end <br /> Uic individast or organizetion notifias thclocel govtrnmcnt unit In«ri�ing t6at tkc rnstarcd�cttla�id mny bo eauidercd iar�cptsccmcnG <br /> PertII: Addiftonnlas#urancos(eheckaltthatapply); <br /> OO Ttie hetland i4itE 6c rcptarcd beCare or concurrent uiqi U�c astnnt drainingar Glling of e��titland. <br /> (�51 An ir�acable hank letter of crcdit,p;�Tannance bwtd,or otiicr acccptable atcudt��has 6cen providrd to guatante�snccessCul ceniplttia�of tUs�troltaad replaceiYient. <br /> ❑Tlie�►tiU��d iasm�tiitl be rap(nccd�ria n•Ilhdmn�al Crom an aecount in!hc Statc�Vetland Bm4;. <br /> e t C. Far projects imtilvh�g nny proJeet-spec{tic reptncement: ll'ilhin 3d dn���ofoRher racci��ng appro��eil of this npplicatian wbrgi��ii,�g��tirk on ttte ptqjcct,I <br /> �tll record the Ihctazatian of RcsUtetions aruf Corenants on the dred Cor the proptrty on r�hich�ho repfnc�irenl�cetlnad(s}��ill be Iocatcd;and!t�till tu the sante lime <br /> su�ttut prooFofsucli recordfng to t[ie I.GU. <br /> T�tln est ofm� iotivledge bclief,all tnfarmation in Aact!!is tnfe,coirtptete m►d accuratr,and 1 aRimz alf s�atcments in Part A and C,As�re1��s <br /> cl ec�, assurnn ( in P g. <br /> � ��v����� <br /> , t .--- 1� . <br /> Slgna�ire or app/icm�t orttgenr �t� ,1 AN � 8 2 010 <br /> COR LGU USE O\'L1' <br /> Rc ]acement Iwn Is c4eck one• A ro��ea CITY OF ORONO <br /> � h � )• ❑ PP Oappro��eJ�ti�ith conditions(candilimu mtached) ❑I1t�tied <br /> LGU d,/)'iGn!sigrurhvc pn1e <br /> LCU hgs receirrecidence oCti�k end nroaf oCrecordtng of Drclnration of Reshialions and Co��enants for Replaccmertt�Veiland: <br /> Cotmt}�tr/ren retorded Uate Docronea!I!nslgued b��recorrler <br /> LGUa�jjTclol atgnal�rre ph�Q <br /> Alirmnotn LacaVState/Fedtrn!A�plication Forms for 11'ater/1Votland Projects <br /> Page 6 <br />