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s5`L1 i..=L1~I~ ~,'(~.~JL-!Z t:t1IC).1~ ~1C,1 <br />WETLAI~'D REPLACEI4IENT PLAN APPLICATION <br />l~c~I~SCV l,~`~n y nr .5 a c E-ct'-•o. ~ <br />/ / <br />Applicant Address 8~ p~ <br />a0/S (/gin Oj i:c Si. /~, <br />Name and Address/phone of Authorized Agents, Su)~sidiaries, or Consultants involved with <br />wetland draining ~' ~S p%)~ <br /> <br />Provide the following information for the Impacted `Vetlands: <br />(1) a recent aerial photograph or accurate map of the impacted wetland area is attached? <br />_ /_ Yes No ~~ c~•~=-•~~r 1) <br />(2) the location of the wetland: /~c~MsE~- county, ~:wn ~,~, watershed name <br />public land survey and/or UTM coordinates of approximate wetland center <br />NW %fi ` S~ y % 3~,_P~u 7 3 <br />(3) the size of the wetland: -~ 2- acres or square feet; (~ 66 ~~-~~'•~~ k ~) <br />(4) the type of wetland: _, 'vn~ ~ Circular No. 39 P.SSC NtiVI. P.SS~ <br />(5) a list of the dominant vegetation in the impacted wetland area: r-~o <br />(for example, 50 percent willow, 20 percent cattails, and 30 percent sedge) <br />Po nn jr 2_D <br />(~n~ <br />~c,x ~l~~F~ / O <br />(6) a soils map of the site is attached? _~~ Yes No (~~~~»~°n7Z) <br />(7) the size of the surface water drainage into the wetland is 7S acres. <br />(8) a.) the locations of any surface inlets or outl is draining Into or out of the wetlands are <br />noted? / Yes No, ~/-I Yt~ct, 3 ) <br />b.) is the wetland within the floodplain of a watercourse? <br />Yes / No; if Yes, the distance and direction to the watercourse <br />is feet in a direction. <br />(9) is a map, photograph, or written description of the land use of the immediate watershed <br />within one mile of the impacted wetland attached? ~ Yes No. Does the ~/a1~ ~~ `~~ <br />description note the presence and location, if any, of wetland preservation regions and <br />areas, wetland development avoidance regions and areas, and wetland deficient regions and <br />areas as identified in the comprehensive water plan? ';~ Yes No. /?one <br />(10) Is the nature of the proposed project, its areal extent, and the impact on the wetland shown <br />in sufficient detail on the materials submitted? _~ Yes No. <br />(11) Has evidence of ownership or rights to the affected areas by all applicants been <br />demonstrated? _~ Yes _ No. <br />1 <br />