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<br />APPLICATION FOR WITHDRAWAL OF WETLAND CREDITS <br />FROM THE MINNESOTA WETLAND BANK <br /> <br />Return Original to BWSR - Transaction may not be processed without original signatures <br /> <br />2. Impact Site Information <br /> <br />1. PROPOSED USER OF CREDITS <br /> <br />Name(s) City ofCenterville (Dallas Larson) <br /> <br />County Anoka Major Wtrshd No.20 <br /> <br />Location: SW% NW1,4 Sec 24, Twp.31, Rge 22 <br /> <br />Size of Wetland Impact: 0.71 acres <br /> <br />Wetland Types2 Impacted: 1 <br /> <br />Topo Settin~: Tributary [pick one: shoreland 1 riverine 1 <br />floodplain flow through 1 tributary 1 isolated] <br />Required Replacement Ratio: 2: 1 WCA 1 local 1 COE <br />Amount to be replaced using Bank Credits: 1.43 ac <br />Amount replaced on site: 0 <br />Project Name: Centerville Industrial Park Connector Road <br />Attach replacement plan if additional detail is needed. <br /> <br />Address: 1880 Main Street <br />Centenrille,~ 55038 <br />City State ZIP <br /> <br />Day Phone (651 )429-4T5t1 .3:l...f3.il- <br />Other Phone ( ) <br /> <br />3. OWNER 1 SELLER OF CREDITS <br /> <br />4. Regulating Authority(ies) Approving <br />the Use of Wetland Bank Credits <br /> <br />Account No. BWSR Bank <br /> <br />Watershed No. 20 <br /> <br />County: Anoka <br /> <br />Replacement Plan approved by (check all that apply): <br /> <br />~ Local WCA LGU: Rice Creek Watershed District (print <br />agency name) <br />Local Permit #05-110 <br /> <br />Name of Seller: BWSR <br /> <br />(Name of Authorized Representative) <br /> <br /> ncos 6. o transactlon ee. nava eto oar 0 ater 0 esources. <br /> . <br />5. CREDITS ~ROPOSED TO BE WITHDRAWN FROM ACCOuNT NO. <br />Credit Acres Wetland Topo. Settin~ Cost <br />Sub-Group! NWC or PVC withdrawn Type2 (per acre) <br />1 NWC 0.71 ac 1 tributary <br />2 PVC 0.71 ac upland buffer <br /> [pick one] [pick one] <br /> [pick one] [pick one] <br />Totals: <br /> <br />DEI ed sty( <br /> <br />~ U.S. Army Corps of Engineers: Permit #5002-7188- T JF <br />o MN Dept. of Natural Resources: Permit # <br />o Natural Resources Conservation Service: Permit # <br />n OthP.r llnthontv ;nvolv..i1' <br />tI bl "B d fW &S ilR <br /> <br />(Signature of SeIlerl Authorized Representative) <br /> <br />'Letters signifY credit sub-groups, which represent wetland areas with different wetland characteristics. <br />2Circular39 types: I, IL,2, 3,4, 5, 6, 7, 8,R, U (for Upland Buffer). <br />3Topographic setting types: shoreland, riverine, floodplain, flow-through, tributary, isolated. <br />1 acre = 43,560 sq. ft. <br /> <br />Page I of2 <br />BWSR Form: wca-bank-05 (online withdrawal form).doc <br />Revised 1/04/05 <br /> <br />/i <br />