Joint Notification Application 04-22-20104
Memorandum
CITY OF
CIIAN�IASSEN
TO: Greg Grazcyk, Carver County SWCD
Ken Powell, MN BWSR
7700 Market Boulevard
Christina Carballal, US ACOE
PO Box 147
John "Jack" Gleason, MN DNR
Chanhassen, MN 55317
Michael North, MN DNR
COPY: Mark Enochs, CH2MHill for RPBCWD
Administration
Phone: 952.227.1100
DATE: April 22, 2010
Fax: 952.227.1110
Building Inspections
RE: Chanhassen Project PW 10 -02: Audubon Road Reconstruction Project
Phone: 952.227.1180
Joint Notification Application
Fax: 952.227.1190
Engineering
Phone: 952.227.1160
Fax: 952.227.1170
Please find attached to this memorandum a Joint Notification Application for the
Finance
impact and subsequent mitigation plan for 560 square feet of Type 3 wetland adjacent
Phone: 952.227.1140
to Bluff Creek in Chanhassen, MN. The impact is a result of extending the box culvert
Fax: 952.227.1110
under Audubon Road eight feet to the west. The impacts will be mitigated for by
withdrawing 1120 square feet of wetland credit from wetland bank account 127.
Park & Recreation
Phone: 952.227.1120
Also included with this submittal is an exhibit, prepared by SRF showing the delineated
Fax: 952.227.1110
wetland boundary, a drawing of the culvert in both plan view and cross - sectional view
and an application for withdrawal of wetland credits.
Recreation Center
2310 Coulter Boulevard
Phone: 952.227.1400
Comments will be accepted until May 10, 2010. Please direct your comments to:
Fax: 952.227.1404
Terry Jeffery
Planning&
Water Resources Coordinator
Natural Resources
City of Chanhassen
Phone: 952.227.1130
7700 Market Blvd, PO Box 147
Fax: 952227.1110
Chanhassen, MN 55317
Public Works
1591 Park Road
tieffery @ci.chanhassen.mn.us
Phone: 952.227.1300
Fax: 952.227.1310
Your time and attention are appreciated. Should you have any questions or wish to
Senior Center
request additional information, please contact Terry Jeffery at 952.227.1168.
Phone: 952227.1125
Fax: 952.227.1110
Web Site
www.ci.chanhassen.mn.us
Chanhassen is a Community for Life - Providing for Today and Planning for Tomorrow
Minnesota Wetland Conservation Act
Notice of Application
Local Government Unit (LGU) Address
City of Chanhassen 1700 Market Blvd, PO Box 147
Chanhassen, MN 55317
1. PROJECT INFORMATION
Applicant Name
Project Name
Date of
Application
City of Chanhassen
Audubon Road Reconstruction
Application
Number
PW10 -02
April 22,
WAP 10 -01
952.227.1168
❑ Staff
2010
® Governing Board or Council
Type of Application (check all that apply):
❑ Wetland Boundary or Type ❑ No -Loss ❑ Exemption ❑ Sequencing
® Replacement Plan ❑ Banking Plan
Summary and description of proposed vroiect (attach additional sheets as necessa
The City of Chanhassen, as part of their on -going infrastructure maintenance and replacement program,
will be reconstructing Audubon Road from Lake Drive West to Lyman Blvd. As part of this project,
dedicated turn lanes and a multiple use recreational path will be added. In order to accommodate these
additions and maintain a safe clear zone, a total of eight feet needs to be added to the west end of the
existing box culvert which conveys Bluff Creek under Audubon Road. This will result in 560 square feet
of impact to a Type 3 wetland. The City of Chanhassen proposes to mitigate for these losses at a 2:1 ratio
by withdrawing 1120 square feet of Type 3 wetland credits from wetland bank account 127 owned and
managed by the City of Chanhassen.
2. APPLICATION REVIEW AND DECISION
Signing and mailing of this completed form to the appropriate recipients in accordance with 8420.0255, Subp.
3 provides notice that an application was made to the LGU under the Wetland Conservation Act as specified
above. A copy of the application is attached. Comments can be submitted to:
Name and Title of LGU Contact Person
Terry Jeffery
Water Resources Coordinator
Comments must be received by (minimum 15
business -day comment period):
Ma 17, 2010
Address (if different than LGU)
Date, time, and location of decision:
6/14/2010 @ 7:OOPM
Chanhassen Council Chambers
7700 Market Blvd, Chanhassen, MN
Phone Number and E -mail Address
Decision -maker for this application:
952.227.1168
❑ Staff
tjeffery@ci.chanhassen.mn.us
® Governing Board or Council
BWSR Forms 11 -25 -09
Date: 6r,22,2016
Page 1 of 2
3. LIST OF ADDRESSEES
® SWCD TEP member: Greg Graczyk
® BWSR TEP member: Ken Powell
❑ LGU TEP member (if different than LGU Contact):
® DNR TEP member: Mike North
❑ DNR Regional Office (if different than DNR TEP member)
® WD or WMO (if applicable): Mark Enochs, CH2Hill
❑ Applicant (notice only) and Landowner (if different)
❑ Members of the public who requested notice (notice only):
® Corps of Engineers Project Manager (notice only) Christina Carballal
® B WSR Wetland Bank Coordinator (wetland bank plan applications on
4. MAILING INFORMATION
➢For a list of BWSR TEP representatives, see: www.bwsr.state.mn.us/aboutbwsr/workareas/WCA—areas.pdf
➢For a list of DNR TEP representatives, see: www.bwsr.state.mn.us/wetlands/wca/DNR—TEP—contacts.pdf
'I-n r"nrfmant nfNafirral Ra-,n17rr. &q Regional Offices:
NW Region v
NE Region
Central Region
Southern Region
Reg. Env. Assess. Ecol.
Reg. Env. Assess. Ecol.
Reg. Env. Assess. Ecol.
Reg. Env. Assess. Ecol.
Div. Ecol. Resources
Div. Ecol. Resources
Div. Ecol. Resources
Div. Ecol. Resources
2115 Birchmont Beach Rd. NE
1201 E. Hwy. 2
1200 Warner Road
261 Hwy. 15 South
Bemidji, MN 56601
Grand Rapids, MN 55744
St. Paul, MN 55106
New Uhn, MN 56073
For a map of DNR Administrative Regions, see: http://files.dnr.state.mn.us/aboutdnr/dnr—regions.pdf
); a list of Corps of Project Managers, see: www.mvp.usace. army. mil /regulatory/default.asp ?pageid =6
or send to: Dept. of the Army, Corps of Engineers, St. Paul District
ATTN: CO -R, 190 Fifth Street East
St. Paul, MN 55101 -1638
➢For Wetland Bank Plan applications, also send a copy of the application to:
Minnesota Board of Water and Soil Resources
Wetland Bank Coordinator
520 Lafayette Road North
St. Paul, MN 55155
5. ATTACHMENTS
In addition to the application, list any other attachments:
® Plan and Profile View of Crossing
® Narrative
BWSR Forms 11 -25 -09 Page 2 of 2
NA- 026620 -03B
(V.2.02 for MS WORD) 9/17/2007
Minnesota Local /State /Federal Application Form for Water/Wetland Projects
For Internal Use Only
Application No. Field Office Code Date Initial Applica Received Da initial Application Deemed Complete
PART I: BASIC APPLICATION
"See HELP" directs you to important additional information and assistance in Instructions, Page 1.
1. LANDOWNER/APPLICANT CONTACT INFORMATION (See Help 1)
Name: City of Chanhassen, Attn: Todd Gerhardt Phone: 952.227.1100 E -mail: tgerhardt @ci.chanhassen.mn.us
Complete mailing address: 7700 Market Blvd, PO 147, Chanhassen, MN 55317
IA. AUTHORIZED AGENT (See Help IA) (Only if applicable, an agent is not required)
Name: Terrance Jeffery Phone: 952.227.1168 E -mail: tjeffery@ci.chanhassen.mn.us
Complete mailing address: 7700 Market Blvd, PO 147, Chanhassen, MN 55317
2. NAME, TYPE AND SIZE OF PUBLIC WATERS or WETLANDS IMPACTED (Attach Additional Project Area sheets if needed)
Name or I.D. # of Waters Impacted (if applicable; if known): Bluff Creek
(Check all that apply): ❑ Lake ® River ❑ Circular 39 Wetland type: ® 1, ❑ 1L, ❑ 2, ❑ 3, ❑ 4, ❑ 5, ❑ 6, ❑ 7, ❑ 8
Wetland plant community type ❑ shallow open water, ❑ deep marsh, ❑ shallow marsh, ❑ sedge meadow, ❑ fresh meadow,
❑ wet to wet -mesic prairie, ❑ calcareous fen, ❑ open bog or coniferous bog, ❑ shrub -carr /alder thicket,
❑ hardwood swamp or coniferous swamp, ❑ floodplain forest, ® seasonally flooded basin
Indicate size of entire lake or wetland (check one): ® Less than 10 acres (indicate size: 0.46 ac) ❑ 10 to 40 acres ❑ Greater than 40 acres
3. PROJECT LOCATION (Information can be found on property tax statement, property title or title insurance):
Project street address: 8900 & 8950 Audubon Rd Fire #: City (if applicable): Chanhassen
'/4 Section: NE Section: 22 Township #: 116N Range #: 23W County: Carver
Lot #: Block: 1 Subdivision: Sunridge Watershed (name or #) UTM location: N E
Attach a simple site locator map. If needed, include on the map written directions to the site from a known location or landmark, and
provide distances from known locations. Label the sheet SITE LOCATOR MAP.
4. TYPE OF PROJECT: Describe the type of proposed work. Attach TYPE OF PROJECT sheet if needed.
The City of Chanhassen is improving Audubon Road and adding a multiple use trail from Lake Drive West to Lyman Blvd. See attached narrative for
further discussion.
5. PROJECT PURPOSE, DESCRIPTION AND DIMENSIONS: Describe what you plan to do and why it is needed, how you plan to
construct the project with dimensions (length, width, depth), area of impact, and when you propose to construct the project. This is the
most important part of your application. See HELP 5 before completing this section; see What To Include on Plans (Instructions,
page 1). Attach PROJECT DESCRIPTION sheet.
This project is intended to improve the condition and safety fo Audubon Road. See attached narrative for a more detailed discussion.
Footprint of project: acres or 560 square feet drained, filled or excavated.
6. PROJECT ALTERNATIVES: What alternatives to this proposed project have you considered that would avoid or minimize impacts
to wetlands or waters? List at least TWO additional alternatives to your project in Section 5 that avoid wetlands (one of which may be "no
build" or "do nothing "), and explain why you chose to pursue the option described in this application over these alternatives. Attach
PROJECT ALTERNATIVES sheet if needed.
The option to not improve Audubon Road was discussed and dismissed due to safety and capacity concerns. The elimination of the trail was
considered but this was not consistent w/ the City's Comprehensive Plan or Master Parks & Trail Plan. See attached.
7. ADJOINING PROPERTY OWNERS: For projects that impact more than 10,000 square feet of water or wetlands, list the complete
mailing addresses of adjacent property owners on an attached separate sheet. (See HELP 7)
8. PORTION OF WORK COMPLETED: Is any portion of the work in wetland or water areas already completed? ❑ Yes ❑No. If
yes, describe the completed work on a separate sheet of paper labeled WORK ALREADY COMPLETED. (See HELP 8)
9. STATUS OF OTHER APPROVALS: List any other permits, reviews or approvals related to this proposed project that are either pending or
have already been approved or denied on a separate attached sheet. See HELP 9.
10. I am applying for state and local authorization to conduct the work described in this application. I am familiar with the information
contained in this application. To the best of my knowledge and belief, all information in Part I is true, complete, and accurate. I possess
the authority to unliertake the work described, or I am acting as the duly authorize the applicant.
ignature of applicant (Landowner) Date Signat e o agent (if applicable) Date
This block must be signed by the person who desires to undertake the proposed activity and has the necessary property rights to do so. If only the Agent has signed, please attach a separate sheet signed by the landowner,
giving necessary authorization to the Agent.
'See Wetland Plants and Plant Communities ojMinnesota and Wisconsin (Eggers and Reed, 1997) as modified by the Board of Water and Son Resources, United States Army Corps of Engineers.
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 1
APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT (33 CFR 325) OMB APPROVAL NO. 0710-003 Expires Dec 31, 2004
The public burden for this collection of information is estimated to average 10 hours per response, although the majority of applications should require 5 hours or less. This includes
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington
Headquarters Service Directorate of Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 222024302; and to the Office of Management
and Budget, Paperwork Reduction Project (0710- 0003), Washington, DC 20503. Respondents should be aware that notwithstanding any other provision of law, no person shall be
subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to
either of these addresses. Completed applications must be submitted to the District engineer having jurisdiction over the location of the proposed activity.
PRIVACY ACT STATEMENT: Authorities: Rivers and Harbors Act, Section 10, 33 USC 403; Clean Water Act, Section 404, 33 USC 1344; Marine Protection, Research and
Sanctuaries Act, 33 USC 1413, Section 103. Principal purpose: Information provided on this form will be used in evaluating the application for a permit. Routine uses: This
information may be shared with the Department of Justice and other Federal, state, and local government agencies. Submission of requested information is voluntary; however, if
information is not provided, the permit application cannot be evaluated nor can a permit be issued
ITEMS 1 THROUGH 4 TO BE FILLED IN BY THE CORPS
1. APPLICATION NO. 12. FIELD OFFICE CODE 13. DATE RECEIVED 14. DATE APPLICATION COMPLETED
YOU DO NOT NEED TO COMPLETE ITEMS 6 -10 and 12 -25 in the SHADED AREAS.
All applicants must complete non - shaded items 5 and 26. If an agent is used, also complete items 8 and 11. This optional Federal form is valid
for use only when included as part of this entire state annlication Dacket.
5. APPLICANT'S NAME 8. AUTHORIZED AGENT'S NAME AND TITLE (an agent is not required)
City of Chanhassen, Attn: Todd Gerhardt
26. Application is hereby made for a permit or permits to authorize the work described in this application. I certify that the information in this
application is complete and accurate. I further certify that I possess the authority to undertake the ork described herein or am acting as the duly
authot)ized agent the applicant.
Signature of applicant Date Signa of age if any) Date
The application must be signed by the person who desires to undertake the proposed activity (applicant), or it may be signed by a duly authorized agent if
the statement in Block 11 has been filled out and signed. 18 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any
department or agency of the United States knowingly and willfully falsifies, conceals, or covers up with any trick, scheme, or disguises a material fact or
makes any false, fictitious or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false,
fictitious or fraudulent statements or entry, shall be fined not more than $10,000 or imprisoned not more than five years or both.
ENG FORM 4345, Jul 97 EDITION OF FEB 94 IS OBSOLETE. (Proponent: CECW -OR)
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 2
11. STATEMENT OF AUTHORIZATION (ifapplicable; complete only ifauthorizing an agent)
I hereby authorize to act on my behalf as my agent in the processing of this application and to furnish, upon request,
FOR LGU USE ONLY:
Determination for Part 1: ❑ No WCA Jurisdiction
❑ Exempt: No. _ (per MN Rule 8420.0122)
❑ No Loss: _ (A,B,...G, per MN Rule 8420.0220)
❑ Wetland Boundary or type
❑ Replacement required — applicant must complete Part Ii
COMPLETE THE SECTION BELOW ONLY IF REPLACEMENT IS NOT REOUIRED:
Application is (check one): ❑ Approved []Approved with conditions (conditions attached) ❑ Denied
Comments/Findings:
LGU official signature Date
Name and Title
For Agricultural and Drainage exemptions (MN Rule 8420.0122 Subps.1 and 213), LGU has received proof of recording of restrictions
(per MN Rule 8420.0115):
County where recorded Date Document # assigned by recorder
LGU official signature Date
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 3
Instructions For Part II
Complete those portions of Part II: Replacement Plan Supplement for which information is readily available (such as location, existing land use, size
of impact area, etc.) A person certified in wetland delineation must determine items pertaining to specific wetland impacts (wetland type,
predominant vegetation, watershed name, etc.) Contact the local soil and water conservation district (SWCD) office for further information on
obtaining such items.
What to Include on Plans
Detailed overhead views of replacement site(s) (Part II), as well as profile view(s) of replacement site(s) (Part II), may be either hand drawn,
computer generated or professionally prepared, as long as they contain all necessary information clearly, accurately, and in adequate detail. Please
include specific dimensions whenever possible. You may also include photos, if you wish.
Overhead views of Part II replacement site(s) should include the following items that pertain to your project:
Property boundaries and/or lot dimensions.
Location and extent of shoreline, wetlands and water.
Location and dimensions of proposed project, structure or activity. Include length, width, elevation and other measurements as appropriate.
Points of reference (such as existing homes, structures, docks or landscape features).
Location of inlet and outlet structures.
Indication of north.
Location of spoil and disposal sites (if applicable).
Areas of wetland and upland plants established.
Profile views (side or cross - sectional views) should include the following items that pertain to your project:
Location and dimensions of proposed project, structure or activity. Include elevation, depth, soil profile, side slope and other
measurements as appropriate.
Proposed water level elevation.
Final Checklists
Part II: Replacement Plan Supplement
❑ Have you completed all of Part II (pages 3 -5)?
❑ Did you (or your agent) sign Section 19 on page 5?
❑ Have you included the necessary attachments for Part II?
Attachments must include:
❑ If the project includes any wetland banking (complete or partial), include Application for Withdrawal of Wetland Credits Form (Section 14)
❑ If the project includes any project - specific replacements (complete or partial), include:
Description of Replacement Wetland(s) Construction (Section 15)
Copy of vegetation management plan (Section 15)
Scale drawing of overhead view or replacement wetland (Section 18)
Scale drawing of profile view of replacement wetland (Section 18)
Attachments may also include:
❑ Additional description of Wetland Impact Charts (Section 11) (if additional space was needed)
❑ Additional Description of Replacement Wetlands charts (Section 17) (if additional space was needed)
❑ Additional soils information for created replacement wetland(s) (Section 18) (if available)
Note: To deposit surplus wetland credits in the State Wetland Bank, submit a Wetland Banking Application directly to your LGU (Section 16).
Preparing Your Application for Mailing
❑ To apply for both state and Federal authorization, your application must include Part I (Page 1), the Federal application (Page 2), and
attachments as indicated on Final Checklist for Part I (Instructions, Page 2).
❑ Your application must also include Part II (Pages 3 -5) and additional attachments as indicated on Final Checklist for Part II (above).
❑ Make three copies of the entire application and all attachments. Keep the original, and mail the three copies to the appropriate local, state,
and Federal agencies (see Instructions for Part I for addresses).
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Instructions Page 3
PART II: REPLACEMENT PLAN SUPPLEMENT
For assistance in completing Part II, contact your Local Government Unit or a professional consultant
11. DESCRIPTION OF WETLAND IMPACTS: Complete the chart below: 1) Use one row of boxes for each wetland impact; 2) If your project has more
than one wetland impact, reference your overhead view (part of Section 5) to this chart by identifying and labeling "first impact" and "second impact" on
your overhead view; 3) If you are identifying only one wetland type within a given wetland impact area, use the first dotted line and leave the others blank;
4) If you have chosen to identify more than one wetland type within a given wetland impact area, use the extra dotted lines to indicate each wetland type, and
identify predominant vegetation and size of impacted area for each separate wetland type within that impact area; 5) If you do not have access to some of
this information, call your LGU or SWCD office for assistance. (Photocopy chartfor more impacts, if needed.)
DESCRIPTION OF WETLAND IMPACTS
Wetland impact
(as noted on
overhead view)
Watershed
name or
number (if
known)
Watershed
and Bank
Service
Wetland plant
community
type'
Predominant
vegetation in
impacted
wetland area
Size of area
impacted
(in acres or
square
feet)
Existing land use in project
area (check all that apply)
33 - MN
9
3
Phalaris
560 SF
® Housing
River
arundinacea
❑ Commercial
First
Shakopee
--------------------------------------------------------
-------- - - - - --
❑ Industrial
impact
❑ Parks /recreation areas
® Highways and
------------------------------
- - - - --
------------ - - - - --
--------- - - - - --
associated rights -of -way
❑ Forested
❑ Farmsteads /agricultural
❑ Vacant lands
❑ Public and semi - public
(schools /gov't facilities)
❑ Airports
Second
------------------------------
- - - - --
------------ - - - - --
---------------
Extractive (gravel
impact
pits /quarries)
--------------------------------------------------------
--------- - - - - --
❑ Other:
' If you are identifying only one wetland type within a given wetland impact area, use the first dotted line and leave the others blank. If you have chosen to identify more
than one wetland type within a given wetland impact area, use the extra dotted lines to indicate each separate wetland type, and identify predominant vegetation and size
of impacted area for each separate wetland type with that impact area.
TOTALS OF AREA(S) IMPACTED FOR EACH WETLAND TYPE ON CHART (indicate acres ❑ or square feet ®)
Wetland plant community type': Shallow open water: Deep marsh: Shallow Marsh: 560 Sedge meadow:
Fresh wet meadow: Wet to wet mesic prairie: Calcareous fen: Open bog or coniferous bog: Shrub carr or alder thicket:
Hardwood swamp or coniferous swamp: Floodplain forest Seasonally flooded basin
12. SPECIAL CONSIDERATIONS: Are you aware of any special considerations that apply to either the impact site(s) or the replacement site(s)? ® Yes ❑ No
(Examples: the presence of endangered species, special fish and wildlife resources, sensitive surface waters, or waste disposal site.) If YES, list and describe briefly.
This wetland is immediately adjacent to Bluff Creek a 303d impaired water.
13. SHORELAND IMPACT ZONE: Please identify each wetland impact site noted in Section 15 that is within 1000 feet of a lake or 300 feet of a river.
This wetland is in a shoreland impact zone.
1 See Wetland Plants and Plant Communities of Minnesota and Wisconsin (Eggers and Reed, 1997) as modified by the Board of Water and
Soil Resources, United States Army Corps of Engineers.
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 4
14. HOW PROPOSED REPLACEMENT WILL BE ACCOMPLISHED: Indicate how proposed replacement will be accomplished (check only one box below
and continue as indicated):
® A. Wetland banking credits only
Complete Application for Withdrawal of Wetland Credits Form and include with your application. Copies of this form are available from your LGU, or
download a copy from www.bwsr.state.mn.us
Skip to Section 19, page 6 (You do not need to complete Sections 15 -18).
❑ B. Project- specific replacement only
Continue with Section 15 below.
❑ C. A Combination of wetland banking and project- specific replacement. If using project specific replacement that will result in surplus wetland credits
that you propose to deposit in the state wetland bank for future use, then you must submit a wetland banking application directly to your LGU before or
concurrently with submittal of this form. Also, Complete Application for Withdrawal of Wetland Credits Form and include with your application. Copies
of this form and the wetland banking application is available from your LGU, or download a copy from www.bwsr.state.mn.us
Continue with Section 15 below.
15. DESCRIPTION OF REPLACEMENT WETLAND(S) CONSTRUCTION (Complete this section only if you marked Box B or Box C in Section
14 above):
Describe in detail how replacement wetland(s) will be constructed. If several methods will be used, describe each method. Details should include the
following: 1) type of construction (such as excavated in upland, restored by tile break, restored by ditch block or revegetated); 2) type, size and
specifications of outlet structures; 3) elevations relative to Mean Sea Level or established benchmarks or key features (such as sill, emergency overflow or
structure height); 4) what best management practices will be implemented to prevent erosions or site degradation; 5) proposed timetable for starting and
ending the project; and 6) a vegetation management plan. Write this description on a separate sheet of paper labeled DESCRIPTION OF REPLACEMENT
WETLAND CONSTRUCTION.
16. SURPLUS WETLAND CREDITS: If using project- specific replacement (Box B or Box C in Section 14 above), will the replacement result in any
surplus wetland credits that you wish to have deposited in the State Wetland Bank for future use? ❑ Yes ❑ No. If yes, submit a Wetland Banking
Application directly to your LGU before or concurrently with submittal of this form. Copies are available from your LGU, or download a copy from
www.bwsr.state.mn.us
17. DESCRIPTION OF REPLACEMENT WETLANDS: Complete the chart below: 1) Use one row of boxes for each wetland replacement site; 2) If
your project has more that one wetland replacement site, reference your overhead view (part of Section 5) to this chart by identifying and labeling "first
replacement site" and "second replacement site" on your overhead view; 3) If you are identifying only one wetland type within a given replacement site, use
the first dotted line(s) and leave the others blank; 4) If you have chosen to identify more than one wetland type in a given replacement site, use the extra dotted
lines to indicate each separate wetland type, and identify type(s) of replacement credits and "restored or created" for each separate wetland type with that
replacement site; 5) If you do not have access to some of the information, or if you do not know your replacement ratio, call your LGU or SWCD office for
assistance. Photocopy chart for more wetland replacements, if needed.)
DESCRIPTION OF REPLACEMENT WETLANDS
Identify
Watershed
County
Section,
Wetland
Type(s) of replacement credits
Restored
Wetland
name or
Township,
Plant
(in acres or square feet)
or
replacement
number
Community
created?
site
(if known)
Range
Type'
New Wetland
Public Value
Indicate
(as noted on
Bank Service
Credits (NWC)
Credits (PVC)
R or C
overhead view)
Area
Name of
Fi rs t ----------
- - - - --
------------- - - - - --
------------------ - - - - --
------- - - - - --
replacement
site ----------
- - - - --
--------------------------------------------
------- - - - - --
Name of
Second ---------
- - - - --
------------ - - - - --
------------------ - - - - --
------- - - - - --
replacement
site
- ----- - - - - --
- --
- -- -- - -- --
------ - - - - --
If you are identifying only one wetland type within a given wetland impact area, use the
first dotted line and leave the others blank. If you have chosen to identify more than one TOTAL NW C TOTAL PVC
wetland type within a given wetland impact area, use the extra dotted lines to indicate each
separate wetland type, and identify predominant vegetation and size of impacted area for REQUIRED REPLACEMENT RATIO'
each separate wetland type within that impact area.
(If known)
Wetland plant community type: Shallow open water: Deep marsh: Shallow Marsh: Sedge meadow:
Fresh wet meadow: Wet to wet mesic prairie: Calcareous fen: Open bog or coniferous bog: Shrub carr or alder thicket:
Hardwood swamp or coniferous swamp: Floodplain forest Seasonally flooded basin
* See Welland Plants and Plant Communities of Minnesota and Wisconsin (Eggers and Reed, 1997) as modified by the Board of Water and
Soil Resources, United States Army Corps of Engineers.
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 5
18. ADDITIONAL INFORMATION REQUIRED FOR PROJECT - SPECIFIC REPLACEMENT (Required only if you marked Box B or Box C in Section 14):
For projects involving at least some project - specific replacement, include the following additional information:
❑ Two drawings to scale of the replacement wetland. Include both overhead view and profile (side view or cross - sectional view). See What to Include on Plans
(Instructions, Page 3) for a detailed description of what should be included in these drawings. Without drawings, your application will be considered incomplete.
❑ For created replacement wetlands, include additional soils information (if available) that indicates the capability of the site to produce and maintain wetland
characteristics.
Note 1: For replacement wetlands located on pipeline easements, you need to receive endorsement of your project from both the easement holder and the Minnesota
Department of Public Safety's Office of Pipeline Safety. Before start of construction, the owner of any utilities must be notified. The landowner or contractor is
responsible for giving this notice by calling "Gopher State One -Call" at 652 -454 -0002 (Twin Cities Metro Area) or 1- 800 - 252 -1166 (all other locations).
Note 2: For extensive or complex projects supplementary information may be requested at a later dated from one or more of the responding agencies.
Such information may include (but not be limited to) the following: topographic map, water table map, soil borings, depth soundings, aerial photographs,
environmental assessment and/or engineering reports.
19. SIGNED AFFIRMATION:
FOR PROJECTS INVOLVING REPLACEMENT BY WETLAND BANKING ONLY. To the best of my knowledge and belief, all information in Part II is true,
complete and accurate; and I affirm that the wetland losses will be replaced via withdrawal from an account in the State Wetland Bank.
FOR PROJECTS INVOLVING EITHER PROJECT - SPECIFIC REPLACEMENT ONLY OR A COMBINATION OF WETLAND BANKING
AND PROJECT - SPECIFIC REPLACEMENT:
Part A: The replacement wetland. I affirm that the replacement wetland was not:
Previously restored or created under a prior approved replacement plan or permit; AND
Drained or filled under an exemption during the previous 10 years; AND
Restored with financial assistance from public conservation programs; AND
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.
Part B: Additional assurances (check all that apply):
® 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 has been provided to guarantee successful completion of the wetland replacement.
❑ The wetland losses will be replaced via withdrawal from an account in the State Wetland Bank.
Part C. For projects involving any project - specific 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 I will at the same time
submit proof of such recording to the LGU.
To the best of my knowledge and belief, all information in Part II is true, complete and accurate; and I affirm all statements in Part A and C, as well as
checked assurance(s) in Part B.
Signature or applicant or agent
FOR LGU USE ONLY
Replacement plan is (check one): ❑ Approved
Date
❑Approved with conditions (conditions attached) ❑ Denied
LGU official signature
Date
LGU has receive evidence of title and proof of recording of Declaration of Restrictions and Covenants for Replacement Wetland:
County where recorded Date
Document # assigned by recorder
LGU official signature
Date
Minnesota Local/State /Federal Application Forms for Water /Wetland Projects
Page 6
APPLICATION FOR WITHDRAWAL OF WETLAND CREDITS
FROM THE MINNESOTA WETLAND BANK
Return Original to BWSR — Transaction may not be processed without original signatures
1. PROPOSED USER OF CREDITS
Name(s) City of Chanhassen
Address: 7700 Market Blvd, PO Box 147
Chanhassen, MN 55317
City State ZIP
Day Phone (952)227.1168
Other Phone (952)227.1160
3. OWNER / SELLER OF CREDITS
Account No. 127 Watershed No. 33
County: Carver Bank Service Area 9
Name of Seller: City of Chanhassen
Terranc o f Authoriz Representative)
S' of Seller /Authorized Representative)
2. Impact Site Information
County carver Major Wtrshd No.33
Bank Service Area 9
Location: '/4 NE %4 Sec 22, Twp.I 16N, Rge 23W
Size of Wetland Impact: 0.01286 acres
Wetland Types Impacted: 3
Wetland Plant Communities impacted Shallow Marsh
Required Replacement Ratio: 2:1 WCA / local / COE
Amount to be replaced using Bank Credits:0.01286
Amount replaced on site: 0
Project Name: Audubon Road Reconstruction Project
Att replacement plan if additional detail is needed.
4. Regulating Authority(ies) Approving
the Use of Wetland Bank Credits
Plan approved by (check all that apply):
® Local WCA LGU: City of Chanhassen (Print agency name)
Local Permit #10 -01
❑ U.S. Army Corps of Engineers: Permit #
❑ MN Dept. of Natural Resources: Permit #
❑ Natural Resources Conservation Service: Permit #
❑ Other authority involved:
❑ Enclosed 6.5% transaction fee, payable to "Board of Water & Soil Resources."
5. CREDITS PROPOSED TO BE WITHDRAWN. FROM ACCOUNT NO. 127
Credit
NWC, PVC
Acres
Wetland
3
Wetland Plant Community
Cost
Sub - Group
or SWC
withdrawn
Type
(per acre)
A
NWC
0.0257
3
Shallow Marsh
$43,166
[pick one]
[pick one]
[pick one]
[Pick One]
[pick one]
[Pick One]
Totals:
1 acre = 43,560 sq. ft. Fee Total (Total cost x 0.065 = s72.11
'.Letters signify credit sub - groups, which represent wetland areas with different wetland characteristics.
2 Circular 39 types: 1, 1L, 2, 3, 4, 5, 6, 7, 8, R, U (for Upland Buffer).
3 Wetland plant community type: shallow open water, deep marsh, shallow marsh, sedge meadow, fresh meadow, wet to wet -mesic prairie,
calcareous fen, open bog or coniferous bog, shrub -carr /alder thicket, hardwood swamp or coniferous swamp, floodplain forest, seasonally
flooded basin, or upland buffer. See Wetland Plants and Plant Communities of Minnesota and Wisconsin (Eggers and Reed, 1997) as
modified by the Board of Water and Soil Resources, United States Army Corps of Engineers.
Page 1 of 2
BWSR Form: wca- bank -05- withdrawal.doc
Revised 10/26/09
6. CERTIFICATION OF USER OF WETLAND CREDITS
The proposed user of credits hereby certifies that he /she: a) either owns the subject wetland credits or has entered into an
agreement to purchase said credits, subject to the approval of all applicable regulatory authorities and b) has filed appropriate
plans, specifications and application forms with all applicable regulatory authorities that describe the wetland or water resource impacts
for which sect nd credits ' 1 be utilized for mitigation purposes.
Todd Gerhardt �v
Aut zed Signature of Proposed User of Credits PRINT Name Date
7. REGULATORY AUTHORITY APPROVAL(S)
The following authorized representatives of the regulatory authority (ies) identified on page 1 of this application hereby certify that
they have: a) verified that the subject wetland credits are deposited in the account of the owner / seller, b) approved a wetland
replacement plan or other water resource impact under their jurisdiction, and c) approved the proposed use of the wetland bank
credits described herein.
Terrance Jeffery
PRINT Name of WCA LGU Official Signature of Authorized WCA LGU Official Date
PRINT Name of Other Regulatory Official (if any) Signature of Other Authorized Official Date
Agency Address of Other Regulatory Official
8. CERTIFICATION OF OWNER / SELLER OF CREDITS
I am the holder of the aforementioned account in the State of Minnesota Wetland Mitigation Bank and hereby certify that:
1) the credits described in this application have either been sold to the user of credits or I will use them to
mitigate wetland impacts for my own project,
2) I have received payment in full from the buyer (if applicable),
3) the credits have not been sold or used in any way to mitigate wetland losses other than for the project
and location identified in the project site information block on the previous page,
4) the subject wetland credits should be withdrawn my account,
5) I will not have a negative balance of credits after the subject credits are debited from my account, and
6) the Annual Fee for this account has been paid (or will be with an enclosed check).
Authorized Signature of Owner / Seller of Credits Date
9. BWSR APPROVAL AND DEBITING OF ACCOUNT
I hereby certify that the credits have been properly debited from the subject account, effective the date of signature.
Authorized Signature Date
Upon approval by BWSR, a copy of this instrument will be mailed to the user of the credits, all regulatory authorities involved, the account holder
and the Board Conservationist. A letter will also be sent to the account holder acknowledging the debit and new account balance.
IMPORTANT REMINDERS
1. The Owner / Seller of the credits is responsible for submittal of this form, containing original signatures, to the BWSR
Wetland Bank Administrator so the affected account can be properly debited.
2. No impacts to any wetland or other water resource may commence until the credits have been debited from the Minnesota
Wetland Mitigation Bank and a copy of this approval has been mailed to the regulatory authority(ies), the account holder and
the user of the credits.
3. It is a criminal offense for a seller of wetland credits to sell credits more than one time. It is the responsibility of the account
holder to report any credit sales that are not noted on the most current official BWSR account balance.
Page 2 of 2
BWSR Form: wca- bank- 05- withdrawal.doc Mail to: Bank Coordinator, Board of Water & Soil Resources
Revised 10/26/09 520 Lafayette Road North St. Paul, MN 55155
8900 AUDUBON ROAD
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X - REMOVE TREE 1. SEE EROSION CONTROL PLANS FOR SILT FENCE LOCATION.
0 - REMOVE SHRUB 2. INSTALL TEMPORARY MAILBOXES PRIOR TO MAILBOX REMOVAL, TEMPORARY MAILBOX
O- SALVAGE AND REINSTALL MAILBOX LOCATION TO BE DETERMINED BY THE ENGINEER IN THE FIELD.
- - — — — — GRADING LIMITS. 3. ALL REMOVALS SHALL BE MARKED BY THE FIELD ENGINEER AND BECOME PROPERTY OF THE
CONTRACTOR TO BE DISPOSED OF OFFSITE.
- TRAIL REMOVAL 4. ALL SALVAGED ITEMS SHALL BE STORED SAFELY UNTIL SUCH TIME THAT THEY ARE
INSTALLED.
- REMOVE BIT PAVEMENT (ALL DEPTHS)
5. REMOVE EXISTING BITUMINOUS PAVEMENT 0+75 TO 44 +00 (ALL DEPTHS)
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