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For Re lacement Plans usin credits from the State Wetland Bank: <br /> Bank Account# Bank Service Area County Credits Approved for <br /> Withdrawal(sq.ft.or nearest <br /> .O 1 acre <br /> Replacement Plan Approval Conditions. In addition to any conditions specified by the LGU, the <br /> approval of a Wetland Re�lacement Plan is conditional upon the following: <br /> ❑Financial Assurance:For project-specific replacement that is not in-advance,a financial assurance <br /> specified by the LGU must be submitted to the LGU in accordance with NIN Rule 8420.0522, Subp.9 <br /> (List amount and type in LGU Findings). <br /> ❑Deed Recording:For project-spec�c replacement,evidence must be provided to the LGU that the <br /> BWSR"Declaration of Restrictions and Covenants" and "Consent to Replacement Wetland" forms <br /> have been filed with the county recorder's office in which the replacement wetland is located. <br /> ❑Credit Withdrawal:For replacement consisting of wetland bank credits,confirmation that BWSR <br /> has withdrawn the credits from the state wetland bank as specified in the approved replacement plan. <br /> Wetlands may not be impacted until all applicable conditions have been met! <br /> LGU Authorized Si ature: ' <br /> Signing and mailing of this completed form to the appropriate recipients in accordance with 8420.0255, <br /> Subp. 5 provides notice that a decision was made by the LGU under the Wetland Conservation Act as <br /> specified above. If additional details on the decision exist,they have been provided to the landowner <br /> and are available from the LGU u on re uest. <br /> Name Title <br /> Courtney Hall Wetland Specialist <br /> Signature Date Phone Number and E-mail <br /> (952)473-2855 <br /> 9���� chall@minnehahacreek.org <br /> THIS DECISIO ONLY APPLIES TO TI� MINNESOTA WETLAND CONSERVATION ACT. <br /> Additional approvals or permits from local, state, and federal agencies may be required. Check with all <br /> appropriate authorities before commencing work in or near wetlands. <br /> Applicants proceed at their own risk if work authorized by this decision is started before the time period <br /> for appeal(30 days)has expired.If this decision is reversed or revised under appeal,the applicant may be <br /> responsible for restoring or replacing all wetland impacts. <br /> This decision is valid for three years from the date of decision unless a longer period is advised by the TEP <br /> and specified in this notice of decision. <br /> 3.APPEAL OF THIS DECISION <br /> Pursuant to MN Rule 8420.0905,any appeal of this decision can only be commenced by mailing a petition <br /> for appeal,including applicable fee,within thirty(30)calendar days of the date of the mailin�of this Notice <br /> to the following as indicated: <br /> Check one: <br /> � Appeal of an LGU staff decision. Send ❑Appeal of LGU governing body decision. <br /> petition and$0 fee(if applicable)to: Send petition and$500 filing fee to: <br /> Minnehaha Creek Watershed District Executive Director <br /> 15320 Minnetonka Blvd Minnesota Board of Water and Soil Resources <br /> Minnetonka,MN 55391 520 Lafayette Road North <br /> St. Paul, MN 55155 <br /> BWSR Forms 7-1-10 Page 2 <br /> of 3 <br />