HomeMy WebLinkAboutWetland Alteration Guidelines: Excavation of Ponds O
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� ,� CITY of ORONO
\\ , 1° , ti Municipal Offices
11 �� G� Street Address: Mailing Address:
\EggO 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Wetland Alteration Guidelines: Excavation of Ponds
1. Excavation of ponds in upland areas (not within nor within 26' of a Type 1 thru Type 8 wetland)
requires a staff-issued land alteration permit if not more than 500 cubic yards, and a Conditional Use Permit
(CUP) if more than 500 cubic yards. Such grading may require a permit fom the MCWD.
2. Excavation of a pond in a WCA wetland that is not a City-protected wetland, will require MCWD
approval as well as a City land alteration permit (and a CUP if over 500 c.y.), and may require U.S. Army
Corps of Engineers approval.
3. Excavation of a pond in or within 26' of a City-protected wetland, will require a Variance and
Conditional Use Permit approval regardless of the amount of excavation; likely will require MCWD and
Corps approval; and may require DNR approval if it is a DNR-protected wetland.
4. City approval of pond excavations will take into account the applicable requirements and review
considerations as defined in Zoning Code Sections 10.55 and 10.56.
5. The City will generally not approve a Var/CUP application for a decorative pond in City-protected
wetlands unless such pond is designed to meet minimum wildlife habitat specifications, which generally
include:
- Pond surface area of at least 2500 s.f. - 10:1 perimeter bench to a 1' depth
- Depth of approximately 4-5' - Excavating a small portion of a larger wetland
6. Approval for ponds excavated in City-protected wetlands will normally require the use of erosion
control measures,vegetation restoration,and the granting of a conservation and flowage easement to the City.
7. Information required in order to make application for a Var/CUP for pond excavation includes but is
not limited to:
- Complete General Land Use Application with fee/property owner list/plat map
- Property survey
- Wetland delineation report(must use a professional delineator)
- Grading plan(existing and proposed contours)
- Vegetation restoration plan
- Indication of spoil disposal site
Glossary: WCA: Wetlands Conservation Act MCWD: Minnehaha Creek Watershed District
DNR: Minnesota Department of Natural Resources var: variance CUP: Conditional Use Permit
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
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.NA-02620-02 12.14.00
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-!*"'41;;-0`4712 "r): ,4Application for Department of the,ArmyPermit(33 CFR 325) '
Use these application forms to apply to 1)the appropriate Local Government Unit(LGU),2)the Minnesota Department
of Natural Resources(DNR),and 3)the U.S.Army Corps of Engineers(COE)for authorization of any proposed water/
wetland project affecting lakes, rivers, streams or wetlands that may fall within the jurisdiction of any(or all)of these
three agencies. If 401 certification is required from the Minnesota Pollution Control Agency(MPCA), the COE will forward
these application forms to the MPCA for processing.You do not need to send this application to the MPCA.
This application packet includes the following:
■ PART 1: BASIC APPLICATION must be filled out by all applicants(pages 1-3,plus requested attachments).
•APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT(page 4)must also be completed(non-shaded blocks
only), signed and submitted by the applicant or agent, along with Part 1,to complete the Federal(U.S.Army Corps
of Engineers)component of the application process using these forms.
• PART 2: REPLACEMENT PLAN SUPPLEMENT must be filled out by applicants who need to develop a replacement
plan for wetland mitigation(pages 5-8,plus requested attachments).
■ INSTRUCTIONS(Instructions 1-4)are provided to assist with completion and mailing of the application.
Before beginning work on your project,you must receive all required approvals from your LGU,the DNR and the
U.S. Army Corps of Engineers(COE).If you have not received a reply after 45 days,or if you wish to confirm the status
of your application at any time,contact the agencies directly(see Instructions,page 4). Proceeding with work before
all required authorizations are obtained may result in fines or other penalties.
If you have questions or need assistance with filling out these forms,contact your local Soil and Water Conservation
District(SWCD)office,your LGU,your regional DNR office,or your COE regulatory field office(see Instructions,
page 4).
NOTE 1: If you believe that your project may be subject to Watershed District regulation, local Planning and Zoning
jurisdiction, or any other locally implemented or enacted controls besides those of your LGU, contact the appropriate
office(s)directly in addition to your LGU,the DNR and the COE.
NOTE 2: If you are a Federal Farm Program participant,and if your project affects a wetland or water body on agricultural
land, your eligibility for USDA benefits may be affected. In addition to your LGU,the DNR and the COE, contact your
local Natural Resources Conservation Service(NRCS) office to request and complete the appropriate form before initiat-
ing any activity.
A QUICK LOOK AT THE PERMIT APPLICATION PROCESS
l Send copiesof these completed application forms 4.When the review process is complete,your application
to your LGU,your regional DNR office,and your COE will either be approved,approved with changes or conditions,
regulatory field office. withdrawn,or.denied.You will be informed of the decision.
2.Any of the agencies may make initial contact with you 5.For information about laws,rules and regulations that direct
to a)inform you that it has no jurisdiction over your project; this process,the,website www.revisor.leg.state.mn.us includes
b)request additional information needed;or c)inform you complete State of Minnesota waters and wetlands laws and
of applicable fees. rules,and the website www.mvp.usace.army.mil provides
information on U,S.Army Corps of Engineers regulations.
3.When your application is considered complete and
appropriate fees have been received(if requested), 6.For information on the appeals process,contact the appro-
your application will be distributed for appropriate agency priate agency(see Instructions,page 4).
review and public comments.
NA-02620-02 12.14.00 .
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-at°4 eS0 1 L.ocaUState/Federal , ppltcatlonaForms for Water/Wedand Projects
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PART 1:
BASIC APPLICATION
"See HELP"directs you to important additional information and assistance in Instructions,page 1.
1.APPLICANT CONTACT INFORMATION (See HELP 1):
f� 1A.AUTHORIZED AGENT (See HELP 1A.)
Name:
Sexd o✓�1 2� (only if applicable; an agent is not required
Complete mailing address: Name:
9 70 L4/%,y 24/' 48/ud £ Title:
141417 Z 4/1 4/h S'53 cj l Mailing address:
Residential phone: ( 9s2) I/26— f 2£13
Residential phone: ( )
Business phone: ( )
Business phone: ( )
Fax (if available): ( ) Fax(if available): ( )
email (if available): email (if available):
2. PROJECT NAME OR TITLE(if applicable): I hereby authorize
to act in my behalf as an agent in the processing of
this application and to furnish,upon request, supple-
mental nfo tion in support of this application.
3.NAME OR I.D.#OF WATER BODY/BODIES IMPACTED**
i applicable; i known): Z r f—dY
(f Pp fApplicant signature Date
4a.ANY WETLANDS IMPACTED?(circle one) IV NO 4c.If YES,indicate size of entire wetland(check one):
4b. If YES,what type(if known; circle all that apply): i Less than 10 acres(indicate size: 12 /14,12- )
�
0 10 to 40 acres
1 1L 2 (3J 4 5 6 7 8 R unknown 0 Greater than 40 acres
5. PROJECT LOCATION** (information can be found on property tax statement,property title or title insurance):
1/4 section:/-4,7<7
S L" Section: .?( Township: //g Range: 2$
County: /J/,7h Lot#: Block: Subdivision:
6.ADDITIONAL LOCATION DESCRIPTIONS** (f applicable; if known): Parcel ID#/Geocode:
UTM coordinates: easterly northerly
Project street address: Fire#:
**For multiple water bodies or locations,attach additional sheets labeled ADDITIONAL WATER BODIES IMPACTED,
ADDITIONAL PROJECT LOCATIONS, or ADDITIONAL LOCATION DESCRIPTIONS.
1
•
7. HOW TO GET TO THE SITE Attach a simple site locator map. If needed, include on the map written directions to the site
from a known location or landmark. Include highway and street names and numbers.Also provide distances from known
locations and any other information that would assist in locating the site. Label the sheet SITE LOCATOR MAP.
8. PURPOSE OF PROJECT: What do you propose to do,and why is it needed?Please be brief. (See HELP 8
before
completing this section.) ti, a y t 2 re d- 1474/ A4 E: ,be.er Tj/7ec/'
ih by Seri"hesi7'- 71);.s. cud/ harp
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9. PROPOSED TIMELINE:Approximate project start date: 31br)h, 'e'/ Projected end date: FY ft' —0/
10. PROJECT DESCRIPTION: Describe in detail what you plan to do and how you plan to do it. This is the most important
part of your application.See HELP 10 before completing this section;see also What To Include on Plans(Instructions,
page 2). If space below is not adequate, attach separate sheet labeled PROJECT DESCRIPTION.
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11. FOOTPRINT OF IMPACT(if applicable): Indicate total amount(in acres or square feet)of wetland(s)or water body
area(s)to be filled, drained, inundated or excavated;and/or indicate length of stream or river affected(in linear feet).
/i (
c acres or� �000 square feet and/or linear feet
12.TYPE AND ESTIMATED AMOUNT OF MATERIALIS)TO BE PLACED INTO OR EXCAVATED FROM THE WETLAND
OR WATER BODY (if applicable): List each type of material(such as rock, sand,clay,concrete)to be filled or excavated,
and estimate amount in cubic yards.
❑ FILLING EXCAVATING
Type(s)of material Estimated amount in cubic yards Type(s) of material Estimated amount in cubic yards
tri 1r 2e4,0
•
13. ESTIMATED PROJECT COST: �ae (for determination ofDNR fees only, which are based on total project cost)
2
14. SEQUENCING CONSIDERATIONS: What alternatives to this proposed project have you considered that could have
avoided or minimized impacts to wetlands or water?List at least two alternatives(one of which may be"no build"
or"do nothing"),and explain why you chose to pursue the option described in this application over these alternatives.
I ("yid 4(4' /7 0/1 h, / he-rt f,& 4,3//j r - n 4,74 A i'//
ruhui F vde,2 L..44 I/
15. PORTION OF WORK ALREADY COMPLETED: Is any portion of the work already completed? Alb b If yes,
describe the completed work on a separate sheet of paper labeled WORK ALREADY COMPLETED. (See HELP 15
before completing this section.)
16.ADJOINING PROPERTY OWNERS: For projects that impact more than 10,000 square feet of water or wetlands, list
below complete names and mailing addresses of adjacent property owners whose property also adjoins the wetland
or water body where the work is being proposed. (See HELP 16. If necessary,attach a separate sheet labeled ADJOINING
PROPERTY OWNERS.)
Complete name(s) Complete mailing address (including street address, city, state, zip code)
17.STATUS OF OTHER APPROVALS:List any other permits,reviews or approvals related to this proposed project
that are either pending or have already been approved or denied. See HELP 17
if already applied for
Agency Type of approval ID number Date applied for Dale approved Dale denied
•
18. I am applying for state and local authorization to conduct the work described in this application. I am familiar
with the information contained in this application.To the best of my knowledge and belief, all information in Part 1
is true,complete and accurate. I possess the authority to undertake the work described, or I am acting as the duly
authorized agent of the applicant.
Signature of applicant Date OR Signature of agent Date
This block must be signed by the person who desires to undertake the proposed activity(the applicant in Section 1)
or by the applicant's duly authorized agent(if the boxed Section lA has been filled out and signed by the applicant).
Federal authorization: Generally, in addition to state authorization,projects in wetland or water areas also require
Federal authorization from the Corps of Engineers under Section 404 of the Clean Water Act. To apply to the Corps
using this application package,the applicant/agent must complete the modified one-page Federal application form
on page 4 and mail it to the Corps(address on Instructions,page 4)with a copy of the state application.Applicants
may, if they wish,apply only for Corps authorization by using the unmodified Federal application form that is
available from Corps offices or via the Internet at www.mvp.usace.army.mil
3
APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT(33 CFR 325) OMB APPROVAL NO.(RENEWAL PENDING)
The public burden for this collection of information is estimated to average 10 hours per response,although the majority of applications should require 5 hours or less.
This includes the time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the
collection of information.Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this
burden,to Department of Defense,Washington Headquarters Service Directorate of Information Operations and Reports,1215 Jefferson Davis Highway,Suite 1204,
Arlington,VA 22202 4302;and to the Office of Management and Budget,Paperwork Reduction Project(0710-0003),Washington,DC 20503.Respondents should be
aware that notwithstanding any other provision of law,no person shall be subject to any penalty for failing to comply with a collection of information if it does not
display a currently valid OMB control number.Please DO NOT RETURN your form to either of these addresses.Completed applications must be submitted to the
District engineer having jurisdiction over the location of the proposed activity.
PRIVACY ACT STATEMENT:Authorities:Rivers and Harbors Act,Section 10,33 USC 403;Clean Water Act,Section 404,33 USC 1344;Marine Protection,
Research and Sanctuaries Act,33 USC 1413,Section 103.Principal purpose:Information provided on this form will be used in evaluating the application for a permit.
Routine uses:This information may be shared with the Department of Justice and other Federal,state and local government agencies.Submission of requested
information is voluntary;however,if information is not provided,the permit application cannot be evaluated nor can a permit be issued.
ITEMS 1 THROUGH 4 TO BE FILLED IN BY THE CORPS.
1.APPLICATION NO. 2.FIELD OFFICE CODE 3.DATE RECEIVED 4.DATE APPLICATION COMPLETED
YOU ifl0 NOT NEED TO COMPLETE THE SHADED AREAS.
All applicants need to complete non-shaded items 5 and 26.If an agent is to be used,also complete items 8 and 11. 41111111
This optional Federal form is valid for use only when included as a part of this entire state application packet.
5.APP ICANT'S NAME // 8.AUTHORIZED AGENT'S NAME AND TITLE(an agent is not required)
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11. STATEMENT OF AUTHORIZATION(if applicable;complete only if authorizing an agent)
I hereby authorize to act in my behalf as my agent in the processing of this application and to furnish,
upon request,supplemental information in support of this permit application.
APPLICANT'S SIGNATURE: DATE:
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26.Application is hereby made for a permit or permits to authorize the work described in this application.I certify •that the information in this
application is complete and accurate.I further certify that I possess the authority to undertake the work described herein or am acting as the duly
authorized agent of the applicant.
" '4 5 2-i—"/
Signature of applicant Date Signature of agent(if any) Date
The application must be signed by the person who desires to undertake the proposed activity(applicant),or it may besigned by a duly authorized agent if the statement
in Block 1 i has been filled out and signed.18 U.S.C.Section 1001 provides that:Whoever,in any manner within the jurisdiction of any department or agency of the
United States knowingly and willfully falsifies,conceals,or covers up with any trick,scheme or disguises a material fact or makes any false,fictitious or fraudulent
statements or representations or makes or uses any false writing or document knowing same to contain any false,fictitious or fraudulent statements or entry,shall be
fined not more than$10,
000 or imprisoned not more than five years or both.
ENG FORM 4345,Jul 97 EDITION OF FEB 94 IS OBSOLETE. (Proponent:CECW-OR)
4
;Minnesota LocaVState/Federal Application'Forms for Water/Wetland Projects
flO YOU NEED TO COMPLETE PART 2? I •
Part2:'=Replacement Plan Supplement must be completed bk:anyone"who needs to AeveloP -replacement plan
dor viietland mitigation.If you're not sure:whether.your:pro)ect:requires a replacement;„plan f k'
•Call your LOU or SWCD office for guidance as to whether your project will require completing Part 2 'Ifit is
determined that your project will-require wetland replacement,'complete and.submit.Part 2 along.with Part 1. .
■If you prefer,you may.choose to send in`Part'1 only.After reviewing your applica#ion,the responding agencies
= -will let you know if you need to complete and return Part 2.Caution:If your project will require wetland replace
merit,completing and returning both parts immediately is advisable. Submitting Part 1 and Part 2 separately
rather than at the same time may extend the application review process.
PART 2:
REPLACEMENT PLAN SUPPLEMENT
For assistance in completing Part 2, contact your LGU or a professional consultant.
19. DESCRIPTION OF WETLAND IMPACTS: Complete the chart below: I)Use one row of boxes for each wetland impact.
2) If your project has more than one wetland impact, reference your overhead view(part of Section 10)to this chart
by identifying and labelling"first impact"and"second impact"on your overhead view. 3)If you are identifying only
one wetland type within a given wetland impact area, use the first dotted line and leave the others blank. 4)If you have
chosen to identify more than one wetland type within a given wetland impact area, use the extra dotted lines to indicate
each separate wetland type, and identify predominant vegetation and size of impacted area for each separate wetland
type within that impact area. 5) If you do not have access to some of the information, call your LGU or SWCD office
for assistance. (Photocopy chart for more impacts, if needed.)
DESCRIPTION OF WETLAND IMPACTS
Wetland Watershed Is site within Wetland type' Predominant Size of area Existing land use
impact name or 1000 ft of a vegetation in impacted in project area
(as noted number lake or 300 ft impacted wetland (in acres or (check all that apply)
on overhead (N known) of a river? area square feet)
view)
(YES or NO)
O housing
O commercial
First sndrrstnal
impact i parks/recreation areas
O highways and associated
rights-of-way
1 forested
D farnnsteads/agricuftural
O vacant lands
_ O pubic and semi-public
Second (schools/gov't faa'ibes)
O airports
impact _ 11 extractive(gravel pry
quarries)
O other:
'If you are identifying only one wetland type within a given wetland impact area,use the first dotted line and leave the others blank.If you have chosen to identify more
than one wetland type within a given wetland impact area,use the extra dotted lines to indicate each separate wetland type,and identify predominant vegetation and size
of impacted area for each separate wetland type within that impact area.
TOTALS OF AREA(S) IMPACTED FOR EACH WETLAND TYPE ON CHART (indicate acres or square feet):
Type 1: 1 L: 2: 3: 4: 5: 6: 7: 8: R:
5
20. SPECIAL CONSIDERATIONS:Are you aware of any special considerations that apply to either the impact site(s)
or the replacement site(s)? (Examples: the presence of endangered species, special fish and wildlife resources,
sensitive surface waters, or waste disposal sites)If YES, list and describe briefly.
21. ARCHAEOLOGICAL OR CULTURAL RESOURCE DETERMINATIONS: Are you aware of any archaeological
or cultural resource determinations or surveys completed concerning the project or replacement site by the State Historical
Preservation Office (SHPO)or others? If yes, please explain below or attach a copy of any determinations
or surveys.
22. HOW PROPOSED REPLACEMENT WILL BE ACCOMPLISHED: Indicate how proposed replacement will be
accomplished(check only one box below and continue as indicated):
❑A. Wetland banking only
•Complete Application for Withdrawal of Wetland Credits Form and include with your application.
Copies of this form are available from your LGU, or download a copy from www.bwsr.state.mn.us
• Skip to Section 27,page 8. (You do not need to complete Sections 23-26.)
❑ B. Project-specific replacement only
•Continue with Section 23 below.
❑C.A combination of wetland banking and project-specific replacement
•Complete Application for Withdrawal of Wetland Credits Form and include with your application.
Copies are available from your LGU,or download a copy from www.bwsr.state.mn.us
•Continue with Section 23 below.
23. DESCRIPTION OF REPLACEMENT WETLAND(S) CONSTRUCTION (Complete this section only if you marked Box B
or Box C in Section 22 above):Describe in detail how replacement wetland(s)will be constructed.If several methods
will be used, describe each method. Details should include the following: 1)type of construction(such as excavated
in upland,restored by tile break,restored by ditch block or revegetated); 2)type, size and specifications of outlet
structures;3)elevations relative to Mean Sea Level or established benchmarks of key features(such as sill,emergency over-
flow or structure height);4)what best management practices will be implemented to prevent erosion or site degradation;
5)proposed timetable for starting and ending the project; and 6)a vegetation management plan.Write this description
on a separate sheet of paper labeled DESCRIPTION OF REPLACEMENT WETLAND CONSTRUCTION.
24. SURPLUS WETLAND CREDITS: If using project-specific replacement(Box B or Box C in Section 22 above),will the
replacement result in any surplus wetland credits that you wish to have deposited in the State Wetland Bank for future
use?(indicate YES or NO) If yes,submit a Wetland Banking Application directly to your LGU. Copies are
available from your LGU,or download a copy from www.bwsr.state.mn.us
6
25. DESCRIPTION OF REPLACEMENT WETLANDS Complete the chart below: 1)Use one row of boxes for each
wetland replacement site. 2)If your project has more than one wetland replacement site,reference your overhead view
(part of Section 26)to this chart by identifying and labelling"first replacement site"and"second replacement site"
on your overhead view. 3)If you are identifying only one wetland type within a given replacement site,use the first
dotted line(s)and leave the others blank.4)If you have chosen to identify more than one wetland type in a given replace-
ment site,use the extra dotted lines to indicate each separate wetland type, and identify type(s)of replacement credits
and"restored or created"for each separate wetland type within that replacement site. 5)If you do not have access
to some of the information, or if you do not know your replacement ratio, call your LGU or SWCD office for assistance.
(Photocopy chart for more wetland replacements, if needed.)
DESCRIPTION OF REPLACEMENT WETLANDS
Wetland Watershed County Topographic Wetland Type(s) of replacement credits Restored
replacement name setting' types (in acres or square feet) or
site or number created?
New Wetland Public Value Indicate
(as
erhead view)noted on (if known)
ove rCredits (NWC) Credits (PVC) R or C
First ---- — ----
replacement
site --- — ----
Second ---- — ----"
replacement
site ---- _ ----
'Topographic setting types:Indicate S for Shoreland;R for Riverine;F for Flood-
plain; �NWC TOTAL PVC
FT for Flow-through;T for Tributary;and I for Isolated.
'Circular 39 wetland types:Indicate I, IL,2,3,4,5,6,7,8,R,or U.If you are
identifying only one wetland type within a given wetland impact area,use the first •
dotted line and leave the others blank.If you have chosen to identify more than REQUIRED REPLACEMENT RAT10:
one wetland type within a given wetland impact area,use the extra dotted lines
to indicate each separate wetland type,and identify predominant vegetation and size (if known)
of impacted area for each separate wetland type within that impact area.
26. ADDITIONAL INFORMATION REQUIRED FOR PROJECT-SPECIFIC REPLACEMENT(Required only if you marked
Box B or Box C in Section 22):
For projects involving at least some project-specific replacement,include the following additional information:
❑Two drawings to scale of the replacement wetland. Include both overhead view and profile view(side view
or cross-sectional view). See What To Include on Plans(Instructions,page 2)for a detailed description of what should
be included in these drawings. Without drawings,your application will be considered incomplete.
❑ For created replacement wetlands, include additional soils information (if available) that indicates the capability
of the site to produce and maintain wetland characteristics.
• Note 1: For replacement wetlands located on pipeline easements,you need to receive endorsement of your project
from both the easement holder and the Minnesota Department of Public Safety's Office of Pipeline Safety.
Before start of construction,the owner of any utilities involved must be notified.The landowner or contractor
is responsible for giving this notice by calling"Gopher State One-Call"at 651-454-0002 (Twin Cities Metro Area)
or 1-800-252-1166 (all other locations).
IN Note 2: For extensive or complex projects,supplementary information may be requested at a later date from
one or more of the responding agencies. Such information may include(but not be limited to)the following:
topograhic map,water table map,soil borings, depth soundings,aerial photographs, environmental assessment
and/or engineering reports.
7
27. SIGNED AFFIRMATIONS: Sign and date either Box 27a or Box 27b below. If your project involves replacement
by wetland banking only, sign Box 27a. For all other projects, read Box 27b, check appropriate boxes in Part B,and sign.
27a. For projects involving replacement by wetland banking only:
To the best of my knowledge and belief,all information in Part 2 is true, complete and accurate; and I affirm
that the wetland losses will be replaced via withdrawal from an account in the State Wetland Bank.
Signature of applicant or agent Date
27b. For projects involving either project-specific replacement only or a combination of wetland banking
and project-specific replacement:
Part A:The replacement wetland (affirm all statements):
•Was not previously restored or created under a prior approved replacement plan;AND
■Was not drained or filled under an exemption during the previous 10 years;AND
■Was not restored with financial assistance from public conservation programs;AND
■Was not restored using private funds,other than those of the landowner,unless the funds are paid back
with interest to the individual or organization that funded the restoration; and the individual or organization
notifies the local government unit in writing that the restored wetland may be considered for replacement.
Part B:Additional assurances(check all that apply):
❑The wetland will be replaced before or concurrent with the actual draining or filling of a wetland.
❑An irrevocable bank letter of credit,performance bond, or other acceptable security has been provided
to guarantee the successful completion of the wetland replacement.
❑The wetland losses will be replaced via withdrawal from an account in the State Wetland Bank.
Part C: For projects involving any project-specific replacement: Within 30 days of either receiving approval
of this application or beginning work on the project,I will record the Declaration of Restrictions and Covenants
on the deed for the property on which the replacement wetland(s) will be located; and I will at the same time
submit proof of such recording to the LGU.
To the best of my knowledge and belief,all information in Part 2 is true,complete and accurate; and I affirm
all statements in Parts A and C,as well as checked assurance(s)in Part B.
Signature of applicant or agent Date
FOR LGU USE ONLY
Replacement plan is(check one): O Approved D Approved with conditions(conditions attached) O Denied
LGU official signature Date
LGU has received evidence of title and proof of recording of Declaration of Restrictions and Covenants for Replacement Wetland:
County where recorded Date recorded Document#assigned by recorder
LGU official signature Date
8
INSTRUCTIONS
Instructions for Part 1 Instructions page ,
} What To Include on Plans .Instructions page 2
Final Checklists Instructions pages 2-3
.Preparing Your Application for MailingInstructions page 3
°
Mailing Your Application: Instructions page 4
Instructions for Part 1
HELP 1: Every applicant needs to fill out Section 1 with the name of the responsible party. If the responsible party is
an agency,company,corporation or other organization, indicate the responsible officer and title in the Name line. If more
than one party is associated with the application,attach a separate sheet labeled APPLICANT CONTACT INFORMATION.
HELP 1k Fill out Section 1A only if you have designated an authorized agent.An authorized agent is an individual or
agency,designated by you,to represent you in this process.An agent can be an attorney,builder,consultant,contractor,
engineer, or any other person or organization.An agent is not required.
HELP 8: Purpose of project:Indicate briefly(in a sentence or two)what you propose to do and why it is needed. Include,
if appropriate,a brief description of any related activities or benefits occurring as a result of the proposed project.
HELP 10: Describe in detail what you plan to do and how you plan to do it.Include in your written description any
of the following elements that apply to your project. Do not write on this instruction sheet.Instead, include in your written
description a discussion of applicable components below:
■Whether your project will include such activities as construction, filling,draining,dewatering,removing,
excavating or repair.
■Whether you will be constructing something, such as an access path,bridge,culvert, dam,ditch,dock, driveway,
riprap,road, sandblanket or tile line.
■The proposed dimensions of any structures,such as wingwalls or dikes,as well as what the structures would be
made of and what method(s)would be used to do the work.
■Whether you will be constructing any structures on fill,piles or a float-supported platform.If so,describe.
■Whether you will be dredging or discharging(placing fill material)into a wetland or other water body(including
the temporary placement of material). If so, explain the specific purpose of the placement of the material (such as
erosion control)and indicate how it will be done(such as with a backhoe or dragline). If dredged material is to be
discharged on an upland site, identify the site,and indicate the steps that will be taken(if necessary)to prevent runoff
from the dredged material back into the wetland or water body. Describe the characteristics of the soil you are
discharging,dredging or excavating.
■Your description must also include a detailed overhead view that clearly depicts the work to be undertaken.
See What To Include on Plans(Instructions,page 2).
HELP 15: If any part of the work has already been completed,describe the area already developed. Include
a description of structures completed; any dredged or fill material already discharged(including type of material
and volume in cubic yards);acres or square feet filled(if a wetland or other water body); and whether the work
was done under an existing permit(if so,identify the authorization,if possible).
HELP 16:For information regarding adjacent landowners, contact the city or county tax assessor where the project
is to be developed.
HELP 17:Other permits, reviews or approvals related to the project may include the following: conditional use permit;
plat approval; zoning variance;National Pollutant Discharge Elimination System permit; state disposal system permit
(includes dredged material disposal); watershed district/watershed management organization permit(stonnwater, erosion,
floodplain); environmental assessment worksheet/environmental impact statement;hazardous waste site; feedlot permit;
groundwater appropriation permit; or county/township driveway/road permit.
Instructions 1
What To Include on Plans (Parts 1 and 2)
Detailed overhead views of impact site(s)(Part 1)and replacement site(s)(Part 2),as well as profile view(s)of replace-
ment site(s)(Part 2),may be either hand drawn,computer generated or professionally prepared,as long as they contain all
necessary information clearly,accurately, and in adequate detail.Please include specific dimensions whenever possible.
You may also include photos,if you wish.
■Overhead views of Part 1 impact site(s)and Part 2 replacement site(s)should include the following items that pertain
to your project:
1.Property boundaries and/or lot dimensions
2. Location and extent of shoreline,wetlands and water
3. Location and dimensions of proposed project, structure or activity. Include length, width,elevation
and other measurements as appropriate.
4. Points of reference(such as existing homes, structures,docks or landscape features)
5. Location of inlet and outlet structures
6. Indication of north
7. Location of spoil and disposal sites (if applicable)
8.Location of photo reference points for future monitoring
—Required for Part 2 replacement drawing
—Optional for Part 1 impact drawing (provide only if photos are included)
9.Areas of wetland and upland plants established
—Required only for Part 2 replacement drawing
• Part 2 only: Profile view (side or cross-sectional view) should include the following items that pertain to your project:
1.Location and dimensions of proposed project,structure or activity.Include elevation,depth,soil profile,
side slope, and other measurements as appropriate.
2.Proposed water level elevation
Final Checklists
Part 1:Basic Application
❑ Have you completed all of Part 1 (pages 1-3),plus the Federal application(page 4)?
❑ Did you (or your agent) sign Box 18 on page 3?
❑ Did you also sign Box 1A on page 1 if you have authorized an agent?
❑ Have you signed the Application for Department of the Anny Permit(page 4)to seek Federal authorization of your project?
❑ Have you included the necessary attachments for Part 1?
Attachments must include:
❑ Site Locator Map(Section 7)
❑Overhead View of Project(Section 10 and HELP 10)
Attachments may also include:
O Applicant Contact Information (HELP 1) (f additional space was needed)
❑Additional Water Bodies Impacted (Section 3),Additional Project Locations(Section 5)
and/or Additional Location Descriptions(Section 6) (if additional space was needed)
❑Project Description(Section 10) (if additional space was needed)
❑Photographs with reference points indicated(What To Include on Plans,Instructions,page 2) (if available)
❑Work Already Completed(Section 15) (if you answered YES)
O Adjoining Property Owners (Section 16) (if additional space was needed)
Instructions 2
Part 2:Replacement Plan Supplement
❑ Have you completed all of Part 2 (pages 5-8)?
❑ Did you (or your agent) sign Box 27a or Box 27b on page 8?
❑ Have you included the necessary attachments for Part 2?
Attachments must include:
❑ If the project includes any wetland banking(complete or partial), include Application for Withdrawal
of Wetland Credits Form (Section 22)
❑ If the project includes any project-specific replacements(complete or partial),include:
• Description of Replacement Wetland(s)Construction(Section 23)
• Copy of vegetation management plan(Section 23)
• Scale drawing of overhead view of replacement wetland(Section 26)
• Scale drawing of profile view of replacement wetland(Section 26)
Attachments may also include:
❑Additional Description of Wetland Impacts charts (Section 19) (if additional space was needed)
❑Copy of any archaeological or cultural resource determinations or surveys(Section 21) (if you answered YES)
❑Additional Description of Replacement Wetlands charts(Section 25) (if additional space was needed)
❑Additional soils information for created replacement wetland(s)(Section 26) (if available)
Note:To deposit surplus wetland credits in the State Wetland Bank,submit a Wetland Banking Application directly
to your LGU (Section 24).
Preparing Your Application for Mailing
El To apply for both state and Federal authorization, your application must include
Part 1 (pages 1-3), the Federal application (page 4), and attachments as indicated
on Final Checklist for Part 1 (Instructions, page 2).
❑ Your application may also include Part 2 (pages 5-8) and additional attachments
as indicated on Final Checklist for Part 2 (above).
❑ Make three copies of the entire application and all attachments. Keep the original,
and mail the three copies to the appropriate local, state and Federal agencies (see
Instructions, page 4).
Instructions 3
L '
•
Mailing Your Application
Mail a complete copy of your application to each of the local,state and Federal entities listed below.Include Part 1,
Part 2 if appropriate, and all attachments.
0 LOCAL: Send to the appropriate Local Government Unit(LGU). If you don't know who your LGU is,contact
your county Soil and Water Conservation District(SWCD)office or the Board of Water and Soil Resources
(BWSR)website (www.bwsr.state.mn.us)for this information. SWCD offices are also listed on the BWSR website.
0 STATE:Send to your regional Minnesota DNR Division of Waters office, attention Regional Hydrologist:
Region 1: 2115 Birchmont Beach Road N.E.
/111011111
1114Bemidji,MN 56601
Phone 218-755-3973
Grand
Region 2: 1201 East HighwayRapids2
, MN 55744
-■ Phone: 218-327-4416
111111 -101111Region3: 1601 Minnesota Drive
1�� �• Brainerd, MN 56401
Phone: 218-828-2605
Region 4: 261 Highway 15 South
���r New Ulm,MN 56073
Phone: 507-359-6053
111161.1W11011041Region 5: 2300 Silver Creek Rd.,N.E.
.....NM= Rochester,MN 55906
Phone: 507-285-7430
Region 6: 1200 Warner Road
St. Paul,MN 55106
Phone: 651-772-7910
0 FEDERAL: Send to the appropriate U.S.Army Corps of Engineers regulatory field office:
Brainerd St. Paul
U.S.Army Corps of Engineers U. S.Army Corps of Engineers
Regulatory Branch Regulatory Branch
Gull Lake Recreation Area Army Corps of Engineers Centre
10867 E. Gull Lake Drive N.W. 190 Fifth Street East
Brainerd,MN 56401-9051 St. Paul, MN 55101-1638
Phone: 218-829-8402 Phone: 651-290-5375
La Crescent Two Harbors
U.S.Army Corps of Engineers U.S.Army Corps of Engineers
Regulatory Branch Regulatory Branch
1114 South Oak Street 1554 Highway 2, Suite 2
La Crescent, MN 55947-1338 Two Harbors, MN 55616
Phone: 507-895-8059 Phone: 218-834-6630
WEBSITES
BWSR: www.bwsr.state.mn.us Corps St. Paul District: www.mvp.usace.army.mil
DNR: www.dnr.state.mn.us MPCA: www.pca.state.mn.us
Instructions 4
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