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� '� � r � r � � i � � <br /> � � • • . • • • � � • • � � � <br /> APPLICANT AND YROJECT LOCATION�ORMATION <br /> Sl�adowood N'aim Homeowners Assooiation <br /> C/O Steve Johnston LGU:MCWD <br /> Name(s)of Applicant Project Location: 1/4nw1/4�v $27 T118R23 <br /> 2335 Shado�uvood Driva UTM Coordinates:Y Y <br /> St.r�et Address County Name/Numbcr:Hcnncpin <br /> �,on�Lake,MN 55356 Minor Watershed Name/Number:20092 <br /> City, State,Zip Code Size of entire wetland: �•� acres <br /> Wetland type: Circular 39 3 ; NWi PT?M I��x <br /> (612�382�804 (6121382-4$04 Check one: � <50°/u� ❑ 50°/n -80%� or❑ >80% <br /> Tel hone (Da (Evenin ) Check one: ❑ A "cultwral land �Non-a .]�,nd <br /> PROPOSED PROJECT DESCRiPTInN <br /> Describe the nature and purpose of the proposed project: Clean roadside ditch along Cox l�ann Roa�i, a private street <br /> constructed aproximately 10 years ago and ma;ntained by the hvme owners association. This road ar�d dit�h were original�y <br /> constnict�ed in upland area as indicate by adjacent vegitaliun Dil�h has extremely flat grade and has bec�me clogged with <br /> catrails, whicll in tucn hav� trappprd secliment. Runoff'no longer flows in ditch on south end. Instead it overflows onto <br /> ruaQway creKtin�an unsafe cnndiaon especially during periods of freeze/thaw. <br /> The ditcli will be excavated to a depth of 18"below the adjacent madway and a!I sediment wiU be removed hom the site. <br /> The ditch will be re-vegetated following excavation. <br /> Timetable:project will begin on//,A.s soon as a permit is issued by MWCD(mo/day/yr)arid will be comp.etEd by//30 days <br /> later. <br /> The wetland activity at the above site qualif es for the following under the Wedand Conservation Act(W(;A)(oheck one): <br /> ❑ No Loss Determination(attach pIans) <br /> � Exemption# 2 (per MN Rulc Chapter 8420.0122) (Note.� �lpplieant is r�sponsibl�for��u��mining the proof <br /> necessary to sl:ow qualifccativr�for tl�c�exerrcpliun cluimed.) <br /> Descr�ption of�xemption Clai�ated: <br /> 3420.0122 Su art 2.D. A r acement lan is not re uircd�'or drainin excavatin or fillin of wettands,exec�pt For <br /> drainin�wetlands that have been in existin�foc more than 25 veats resulHng from rnaintenar�c�an�,repair of exi 'nQ <br /> drainaee svstems other than nublic drainaee svstems_ The road ditch is a non-public draina�e svsten that has been in <br /> existence fior less than 25 vears. <br /> APPLICAI�TT SIGNATYJRE <br /> The iz�fornzation provided for this determination is ttuthful and accurate to the hest of niy lrnowledge. T ensute that,in dtaining, <br /> excavating,or fillir�Che subject wetland under an exem�tion�nobed above;appropi-iat�e erosion control measw�es will be taken to <br /> prevent sedirnentation of the water; the drain,exeavation,or fill will not block fish passage;and the draui,��xcavation,or fill <br /> activity wi11 be conducted in campliance with all other applicable federal, .state, and loeal requireme�ls; inchiding best <br /> manage practices �resource protection rcquirements established under Minnesota Statutvs, Chaptec 103H. � <br /> y-Z Y�03 <br /> (Signa e of App]' t) (Da�� i <br /> Psge 1 of 1 <br /> Cax fann rd cxemption form.doc (April 2003) <br /> znnf-� wxnan�r�r i �na�c»ro vW.r oc�er nuT �n��,��rn <br />