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Project Name and/or Number:Ramsey CQR Wetland Analysis <br /> PART FOUR: Aquatic Resource Impact' Summary <br /> If your proposed project involves a direct or indirect impact to an aquatic resource (wetland, lake, tributary, etc.) identify each <br /> impact in the table below.Include all anticipated impacts,including those expected to be temporary.Attach an overhead view map, <br /> aerial photo,and/or drawing showing all of the aquatic resources in the project area and the location(s)of the proposed impacts. <br /> Label each aquatic resource on the map with a reference number or letter and identify the impacts in the following table. <br /> Aquatic <br /> Type of impact Duration of Existing Plant County,Major <br /> Aquatic Resource Resource Type Community Type(s)(fill,excavate, Impact Overall Size of Watershed <br /> {wetland,lake, #►. <br /> 1D(as noted on drain,or Permanent(P) Size of Impact' Aquatic and Bank <br /> overhead view} remove or Temporary Resource 3 4 Service Area# <br /> vegetation} (T) <br /> tributary etc.} 1 Impact Area of Impact Areas <br /> 'If impacts are temporary;enter the duration of the impacts in days next to the"T". For example,a project with a temporary access fill that <br /> would be removed after 220 days would be entered"T(220)". <br /> rlmpacts less than 0.01 acre should be reported in square feet. Impacts 0.01 acre or greater should be reported as acres and rounded to the <br /> nearest 0.01 acre. Tributary impacts must be reported in linear feet of impact and an area of impact by indicating first the linear feet of impact <br /> along the flowline of the stream followed by the area impact in parentheses). For example,a project that impacts 50 feet of a stream that is 6 <br /> feet wide would be reported as 50 ft(300 square feet). <br /> 3This is generally only applicable if you are applying for a de minimis exemption under MN Rules 8420,0420 Subp.8,otherwise enter"N/A". <br /> 4Use Wetland Pionfs and Plant Community Types of Minnesota and Wisconsin 3rd Ed.as modified in MN Rules 8420.0405 5ubp.2. <br /> sRefer to Major Watershed and Bank Service Area maps in MN Rules 8420.0522 5ubp.7. <br /> If any of the above identified impacts have already occurred,identify which impacts they are and the circumstances associated <br /> with each: <br /> NIA <br /> PART FIVE: Applicant Signature <br /> Check here if you are requesting a pre-application consultation with the Corps and LGU based an the information you have <br /> provided. Regulatory entities will not initiate a formal application review if this box is checked. <br /> By signature below, I attest that the information in this application is complete and accurate. I further attest that I possess the <br /> authority to undertake the work described herein. <br /> Signature: pate: <br /> i <br /> i <br /> 'I <br /> I hereby authorize Bolton&Menk,Inc to act on my behalf as my agent in the processing of this application and to furnish,upon <br /> request,supplemental information in support of this application. <br /> I The term"Impact"as used in this joint application form is a gener€c term used for disclosure purposes to identify <br /> activities that may.require approval from one or more regulatory agencies. For purposes of this form it is not meant to <br /> Indicate whether or not those activities may require mit€gation/replacement. <br /> Page 2 <br />