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Project Name and/or Number: <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 <br />map, aerial photo, and/or drawing showing all of the aquatic resources in the project area and the location(s) of the proposed <br />impacts. Label each aquatic resource on the map with a reference number or letter and identify the impacts in the following table. <br />Aquatic Resourc <br />ID (as noted on <br />overhead view) <br />AREA A* <br />AREA B* <br />AREA C* <br />AREA D <br />AREA E <br />AREA F <br />TOTAL <br />Type of Impact <br />Aquatic <br />(fill, excavate, <br />e <br />drain, or <br />Resource Typ <br />(wetland, lake, <br />tributary etc.) remove <br />vegetation) <br />Wetland <br />FILL <br />Wetland <br />FILL <br />Wetland <br />FILL' <br />Wetland <br />FILL <br />Wetland <br />FILL <br />Wetland <br />FILL <br />Duration of <br />Impact <br />Permanent (P) <br />or Temporary <br />(T)1 <br />Size of Impact' <br />Overall Size of <br />Aquatic <br />Resource 3 <br />P <br />2145sf, 0.05ac <br />P <br />1777sf, 0.05ac <br />P <br />1550sf, 0.04ac <br />P <br />2135sf, 0.05ac <br />P <br />146sf, 0.00ac <br />P <br />50sf.0.00ac <br />7803sf, 0.18ac <br />20ac <br />Existing Plant <br />County, Major <br />W#, <br />Watershed <br />Community <br />Type(s) in <br />and Bank <br />Impact Area <br />Service Area # <br />of Impact Areas <br />TYPE 2 <br />WASHINGTON, <br />FRESH(WET) <br />#20, <br />MEADOW <br />#7 <br />* REFERS TO 2018 DELINEATED WETLAND BOUNDARY. MORE WETLAND WAS PRESENT IN 2018 vs 2012 DUE TO EXPANDING OF <br />WETLAND FROM THE IN -ADVANCE MITIGATION AREA. <br />TOTAL 2012 WETLAND IMPACT=2185sf, 0.05ac TOTAL 2018 WETLAND IMPACT=5618sf, 0.13ac <br />llf 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 />2Impacts 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 Plants and Plant Community Types of Minnesota and Wisconsin 3`d Ed. as modified in MN Rules 8420.0405 Subp. 2. <br />SRefer to Major Watershed and Bank Service Area maps in MN Rules 8420.0522 Subp. 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 />No wetland impact has occurred to date. <br />1 The term "impact" as used in this joint application form is a generic 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 mitigation/replacement. <br />Minnesota Interagency Water Resource Application Form February 2014 Page 5 of 16 <br />