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Technical Evaluation Panel Concurrence: <br />Project Name and/or Number: <br />TEP member: Representing: <br />Concur with road authority's determination of qualification for the local road wetland replacement program? ❑ Yes ❑ No <br />Signature: Date: <br />TEP member: Representing: <br />Concur with road authority's determination of qualification for the local road wetland replacement program? ❑ Yes <br />❑ No <br />Signature: Date: <br />TEP member: Representing: <br />Concur with road authority's determination of qualification for the local road wetland replacement program? ❑ Yes <br />❑ No <br />Signature: Date: <br />TEP member: Representing: <br />Concur with road authority's determination of qualification for the local road wetland replacement program? ❑ Yes <br />❑ No <br />Signature: Date: <br />Upon approval and signature by the TEP, application must be sent to: Wetland Bank Administration <br />Minnesota Board of Water & Soil Resources <br />520 Lafayette Road North <br />Saint Paul, MN 55155 <br />Minnesota Interagency Water Resource Application Form February 2014 <br />Page 11 of 11 <br />