Agenda - Environmental Policy Board - 08/21/2023

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Project Name and/or Number: Attach a map of the existing aquatic resources, associated delineation report, and any documentation of regulatory review or approval. Discuss as necessary: For actions involving construction activities,attach construction plans and specifications with all relevant details. Discuss and provide documentation of a hydrologic and hydraulic analysis of the site to define existing conditions, predict project outcomes, identify specific project performance standards and avoid adverse offsite impacts. Plans and specifications should be prepared by a licensed engineer following standard engineering practices. Discuss anticipated construction sequence and timing: For projects involving vegetation restoration, provide a vegetation establishment plan that includes information on site preparation,seed mixes and plant materials,seeding/planting plan (attach seeding/planting zone map), planting/seeding methods,vegetation maintenance,and an anticipated schedule of activities: For projects involving construction or vegetation restoration, identify and discuss goals and specific outcomes that can be determined for credit allocation. Provide a proposed credit allocation table tied to outcomes: Provide a five-year monitoring plan to address project outcomes and credit allocation: Discuss and provide evidence of ownership or rights to conduct wetland replacement/mitigation on each site: Quantify all proposed wetland credits and compare to wetland impacts to identify a proposed wetland replacement ratio. Discuss how this replacement ratio is consistent with Corps and WCA requirements: By signature below,the applicant attests to the following(only required if application involves project-specific/permittee responsible replacement): • All proposed replacement wetlands were not: • Previously restored or created under a prior approved replacement plan or permit • Drained or filled under an exemption during the previous 10 years • Restored with financial assistance from public conservation programs • Restored using private funds,other than landowner funds, 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. • 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 will be provided to guarantee successful completion of the wetland 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 submit proof of such recording to the LGU and the Corps. Applicant or Representative: Title: Signature: Date: Minnesota Interagency Water Resource Application Form February 2014 Page 9 of 11