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FoR LGU use oNLV: <br />Determination for Parl 1: ^ No WCA Jurisdiction <br />^ Lxempt: No. (per MN Rule 8420.0122) <br />^ No Loss: _ (A,B,_ ..G, per MN Rule 8420.0220) <br />^ Wetland Boundary or type <br />^ Replacement required -applicant must complete Part II <br />COMPLETE THE SECTION BELOW ONI.I' IF REPLACEMENT IS NOT REQUIRED• <br />Application is (check one): ^ Approved ^Approved with conditions (conditions attached) ^ Denied <br />Comments/Findings: <br />LGU off>cial signature Dare <br />Name and Title <br />For Agricultural and Drainage exemptions (MN Rulc 8420.0722 Subps. 7 and 2B), LGU has received proof of recording of restrictions <br />(per MN Rule 8420.0715): <br />County inhere recorded Dare Document M ossigned by recorder <br />LGU offrcial signature Dote <br />Minnesota Local/State(Federal Application Forms for Water/Wetland Projects <br />Page 3 <br />