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Scandia_DNR Recreation grant-application_DRAFT 3-30-26 November 2022 OUTDOOR RECREATION GRANT PRORAM APPLICATION CHECK-LIST Please use this checklist to make sure your application is complete before submitting. Application Deadline: March 31, 2026 (by 11:59 pm) Applicants should focus on projects that will be completed during the 2027/2028 construction seasons. Please note that if your project advances to final selection review, financial documentation will need to be provided including recent financial statements and audit as well as a statement of financial position. A Natural Heritage Review letter will also need to be requested and submitted. Required for all applicants Grant Application ☐ Item 1: Application Summary ☐ Item 2: Project Narrative ☐ Item 3: Project Relation to SCORP ☐ Item 4: Cost Breakdown ☐ Item 5: Project Site Evaluation ☐ Part 1: IPAC Report ☐ Part 2: Conservation Planning Report ☐ Part 3: SHPO Data Search ☐ Part 4: Description of Environmental Impact of Proposed Project ☐ Part 5: Environmental Screening Form (ESF) ☐ Part 6: Community Information *NEW Process in 2026* ☐ Item 6: Public Participation and Benefit ☐ Item 7: Availability for Public Use ☐ Item 8: Statement of Accessibility Attachments ☐ Attachment A – Applicant’s Resolution ☐ Attachment B – Maps ☐ Location Map(s), showing park location within state, county, and community ☐ Boundary Map ☐ Recreational Site Plan ☐ Attachment C – Project Timeline, beginning with Month 1 ☐ Attachment D - Photos of all existing areas of the park (not project area(s) only) ☐ Attachment E – Plans, required for all new and renovated facilities ☐ Buildings, shelters and restrooms plans ☐ Trail, walkway and access route plans ☐ Playground and splash pad plans ☐ Fishing pier plans ☐ Campground plans ☐ Attachment F - Certification not suspended or debarred November 2022 ☐ Attachment G - Certification of no conviction of felony financial crime ☐ Attachment H - Federal Appraisal, required for all land acquisition projects November 2022 ITEM 1 - APPLICATION SUMMARY – 2026 APPLICATION Use the 2026 Grant Application template, as requirements have changed. Using prior templates places applicants at risk of excluding required information. Please keep the application intact. DO NOT delete questions that are irrelevant to your project or change numbering. Applicant Information Name of applicant: City of Scandia Name and title of contact: Kyle Morell, City Administrator Address: 14727 209th Street North City: Scandia State: MN Zip Code: 55073 Phone: 651-433-2274 Email: k.morell@ci.scandia.mn.us ☒ The point of contact for this project has read the Outdoor Recreation Grant Program Manual (acknowledge by checking the box). Park Information Park Name: WATER TOWER BARN SCANDIA arts and heritage center Park Address: 20835 Olinda Trail North City: Scandia Nine Digit Zip Code: 55073-8503 County: Washington Township, Section, Range: N/A Existing Park Acres: 6 Project Information Project Type (Check all that apply to this project): ☐ Acquisition: Acres to be purchased: Click to enter amount. ☒ New Development/Construction ☐ Redevelopment/ Rehabilitation ☐ Replacement/ Demolition Description: Provide a short description (less than 30 words) of your project proposal. Include only items that will be accomplished with this project. Do not include work to be accomplished in future phases. Install a “Water Garden Play Area” at the future WATER TOWER BARN SCANDIA arts and heritage center – a freshwater splashpad and children’s play stream with associated amenities. Financial Information The Applicant must provide a match of, at least, 50% of the total cost. This match may consist of cash or the value of materials, labor and equipment usage by the applicant, donations or any November 2022 combination of these. The total project cost shown below must equal the total cost shown in Item 4 – Cost Breakdown. Total Project Cost: $160,000 Grant Request: $80,000 Match Amount: $80,000 Match: List all sources and amounts of the match and identify if it is committed or pending. This program requires a one-to-one match. The match can consist of cash, the value of materials, labor and equipment usage by the local sponsor, donations or any combination thereof. State or federal grants may be eligible for match under this program; however, this may impact the type of award you receive. If you plan to use state or federal funds as part of your match, please contact a Grant Coordinator prior to submission of your application. Applicants who provide at least 20% of the match from their own resources and/or have their match committed at the time of the application will receive additional consideration in the review. Matching Share Contributors (Name and funding source): Match Amount/Value Type (cash, donated land, etc.) Is Match Secured or firmly committed. If committed, list date expected to be secured. Scandia Heritage Alliance – via donations made from Security State Bank of Marine ($50,000), Scandia- Marine Lions Club ($25,000), and Osceola Community Health Foundation ($5,000) $80,000 Cash Secured GRAND TOTAL $80,000 November 2022 ITEM 2 - PROJECT NARRATIVE Please limit each response to 1-2 paragraphs, no more than 250 words per paragraph. 1. Provide a general overview of what the project involves and what will be accomplished by the completion of the proposed project. Discuss why this project is needed at this time. Identify new facilities that will be constructed, existing facilities that will be renovated or replaced (specify which), or the general site improvements that will be completed with the requested funding. Just 40 minutes from the Twin Cities of Minneapolis/St. Paul, the Scandia countryside offers forested trails, access to the St. Croix River, and a rural character that draws visitors seeking authentic small-town experiences. This summer, the City of Scandia begins construction on two exciting trail projects – 1) a new segment of the state Gateway Trail, initiating connection to William O’Brien State Park, and 2) a “Wetland Trail” adjacent to City Hall that will connect the Gateway Trail to Scandia’s recreational and cultural amenities. This application requests funds for a new recreational asset – a “Water Garden Play Area” inside the future WATER TOWER BARN SCANDIA arts and heritage center – to serve both Scandia residents, as well as tourists enjoying the Gateway Trail and William O’Brien State Park. In partnership with Scandia Heritage Alliance (SHA), the City of Scandia will soon break ground on WATER TOWER BARN SCANDIA, an arts and heritage center that reflects a decade of volunteer leadership and strong public-private partnership. The City owns the parkland, and SHA will provide programming via a lease. The City was awarded $2.2 million in the State Legislature’s 2023 Capital Investment Bill to construct the historic Water Tower Barn and an associated amphitheater – but the appropriation does not include the planned “Water Garden Play Area” – a zero-depth, handicap accessible aquatic play surface (splashpad) plus an associated kids’ play stream. DNR Recreation funds -- plus our secured match – would build these features plus add accessible picnic tables, shade structure, sod, and an accessible path. Other funding for the arts and heritage center (NOT part of this application) will cover standard and handicap parking, accessible walkways throughout the site, accessible restrooms, a drinking fountain, additional outdoor seating, and site landscaping. Why is the project needed at this time? Scandia currently lacks an aquatic recreation facility. Residents must travel outside the community to access splash pads or public pools, which typically include fees. This creates barriers for young families, caregivers, and households with limited transportation and financial capability. As regional temperatures rise and demand for close-to-home recreation increases, the need for safe, free, and accessible water-based play has grown. This project responds directly to that need by providing inclusive outdoor recreation infrastructure within a publicly owned park, available at no cost. 2. What design elements are included that contribute to preserving environmental resources as part of ensuring a quality outdoor recreation experience for present and future generations? November 2022 The Water Tower Barn site is surrounded by wetlands on three sides, making protection of natural resources a central design priority. The project’s civil engineer has collaborated closely with the Carnelian-Marine-St. Croix Watershed District to develop civil plans that protect adjacent wetlands and support long-term watershed health. The splash pad uses fresh water (non-recirculating, no chemicals) and is designed as part of a nature-based water system. Water flows from the splash pad into a children’s play stream, then to a stormwater retention pond and rain garden, where it is naturally filtered before entering the adjacent wetland — supporting groundwater recharge while protecting water quality. The splash pad operates seasonally with push-button, timed activation, ensuring water is used only during active play. Native, pollinator-friendly plantings will be incorporated to reduce irrigation needs and support habitat. The project repurposes an underutilized baseball field, with no tree removal required, minimizing site disturbance. Durable materials will be used to extend lifespan and reduce long-term environmental impact. Beyond physical design, the project supports environmental stewardship through experience and education. The nature-based play stream – inspired by Discovery Hollow at Tamarack Nature Center and the play stream at the award-winning will encourage children and families to engage directly with water and natural processes, fostering an early understanding of watershed systems and conservation. Kids will engage in sensory rich, imaginative play that includes building dams and mini waterfalls, creating bridges with sticks and stones, and rerouting water via channels. Interpretive signage will highlight the role of wetlands and rain gardens in protecting local waterways (funded outside of this recreation project). Overall, the arts and heritage center is designed as a serene, nature-integrated public space that strengthens connections between people and place. With over 250,000 annual visitors to nearby William O’Brien State Park, this project expands access to high-quality outdoor recreation for the Twin Cities metro while reinforcing the importance of protecting Scandia’s rural landscape for future generations. November 2022 3. Who is accessing your park the most? Who has the least access? How does the proposed project address the needs of the users with the least access? Currently, the park is a little-used baseball field, reserved as the future home of WATER TOWER BARN SCANDIA arts and heritage center. We expect the splash pad to be used both by local families with young children, as well as visitors to nearby William O’Brien State Park and families biking the Gateway Trail through Scandia. The arts and heritage center will have trails through and around the surrounding wetlands, as well as open spaces attractive to all ages, inviting multigenerational use. Those with the least access to water-based recreation include households without reliable transportation, young children who cannot safely swim in lakes or the river, individuals with mobility limitations, and lower-income families for whom travel and admission fees create barriers. The proposed splash pad directly addresses these access gaps by providing free, zero-depth water recreation within city limits. Accessible walkways and inclusive design features ensure children and caregivers of varying abilities can participate. By locating the facility within a centrally accessible public park, the project reduces transportation barriers and expands outdoor recreation opportunities for current and future generations. November 2022 ITEM 3 - PROJECT RELATION TO SCORP Discuss how the following Strategic Directions from the soon to be approved 2026-2030 Statewide Comprehensive Outdoor Recreation Plan (SCORP) apply to your project. The SCORP is available at this link. The 2026-2030 SCORP is under review by the National Park Service. Once approved, the SCORP website will be updated with the final document. This application aligns with the 2026-2030 SCORP content. How Does the Project Connect People to the Outdoors? 1. How does the proposed project design and redevelop outdoor recreation facilities so they accommodate varying forms of transportation to your park? Describe the types of transportation used to access your park from your community (e.g., driving, walking, biking, canoe/kayaking, snowmobiling, and ATV riding), including accessible forms of transportation. The proposed Water Garden Play Area is designed to be accessible via multiple forms of transportation, supporting both local residents and regional visitors. For those arriving by car, the site includes convenient on-site parking with accessible spaces and safe pedestrian connections to the play area. Local and regional bike routes will serve WATER TOWER BARN SCANDIA, so bike racks will be available. A new segment of the Gateway Trail through Scandia will soon extend connectivity to William O’Brien State Park, while the City’s new “Wetland Trail” is designed to connect the Gateway Trail to Scandia’s recreational and cultural amenities, including the Water Garden Play Area. The Wetland Trail was conceived as part of the overall site plan and includes extending the sidewalk system along Olinda Trail to WATER TOWER BARN SCANDIA, providing continuous pedestrian access from the Scandia Village Center and Scandia Elementary School. This safe, walkable route supports access for children, families with strollers, and individuals using mobility aids. While direct water access from the St. Croix River is not highly practical due to the 3-mile distance, it is possible for outdoor adventurers to combine paddling and biking—bringing a bicycle by canoe or small boat to William O’Brien State Park and then connecting via the future Gateway Trail to reach the site. 2. How does the park and/or proposed project provide outdoor recreation facilities to encourage use by people with all abilities and backgrounds? Does your park provide accessible seating, bathrooms, drinking water, shade opportunities, informational signs and/or safety features? Please describe. The proposed splashpad is designed as a zero-depth, ADA-accessible facility that supports safe, inclusive outdoor recreation for people of all abilities and backgrounds. Accessible walkways will connect the splash pad to parking areas and other WATER TOWER BARN SCANDIA amenities, ensuring equitable access for pedestrians, strollers, and mobility devices. The site includes accessible seating areas, a drinking fountain, shade opportunities (see landscape plan), and proximity to accessible restroom facilities—supporting comfort and usability for caregivers, older adults, and individuals with mobility challenges. Interpretive signage will highlight the role of wetlands, rain November 2022 gardens, and native plantings in water management and filtration, adding an educational dimension to the experience. The concrete splashpad base will utilize Bomanite Sandscape Texture, a slip-resistant, durable concrete system designed for safety and comfort for bare feet. This will reduce fall risk while supporting long-term maintenance. Overall, the project creates a welcoming, family-friendly environment that supports intergenerational use and reduces barriers to participation. By eliminating cost and incorporating modern safety standards, the Water Garden Play Area expands equitable access to high-quality outdoor recreation for individuals who may face physical, economic, or transportation limitations, aligning with statewide goals for safe, accessible, and sustainable recreation opportunities. 3. How does the proposed project provide high-quality experiences to visitors through thoughtful design, programming, and interpretation? Does your project include development or expansion of facilities to provide high quality experiences? Are interpretive signs provided to enhance the user experience? Water and history are central themes shaping the visitor experience at WATER TOWER BARN SCANDIA, where thoughtful design integrates recreation, learning, and a strong sense of place. The site is surrounded by wetlands on three sides and features a rain garden, wetland trail and boardwalk connecting to City Hall, wetland overlook decks, and a children’s Water Garden Play Area. At the heart of this play area, fresh water from the splashpad will flow into a nature-based children’s play stream with boulders, sand, and native plantings, creating opportunities for tactile play. An old-fashioned hand pump at the top of the stream will allow children to initiate water flow, connecting directly to the site’s historic windmill and water systems. Strategically placed interpretive signage will enhance the visitor experience by explaining how wetlands and rain gardens filter water and protect local lakes, streams, and the St. Croix River. Inside the restored 1895 Water Tower Barn, interactive exhibits about the historic windmill system will invite hands-on exploration, encouraging children to discover how a windmill captures energy and moves water—bringing engineering concepts to life through play. These experiences deepen understanding of the relationship between environment, engineering, and local heritage. The Water Garden Play Area is part of a coordinated, phased development that collectively creates a high-quality outdoor recreation destination. While this specific grant project focuses on the splashpad and play stream, it is intentionally integrated with the broader site plan, where complementary facilities—including trails, gathering spaces, and interpretive elements—are being developed in advance. The splash pad and play stream together create an engaging, interactive water experience, supported by durable materials and a carefully designed layout that prioritizes safety, accessibility, and ease of use. Together, these elements create a layered, immersive visitor experience that encourages play, learning, and meaningful connection to Scandia’s natural and cultural landscape. November 2022 4. Describe how the proposed outdoor recreation facilities and experiences are affordable for people with different economic means. The splash pad will be free and open to the public, ensuring access regardless of income level. This is unique, as even the use of area beaches, lakes, or the St. Croix River generally requires a park pass or water gear such as a life jacket. By providing a no-cost alternative to fee-based aquatic facilities, the project reduces financial barriers for families and individuals seeking outdoor recreation. Its location within the community further minimizes transportation costs, making it an accessible option for a wide range of users. Does the Project Acquire Land and/or Create Opportunities? Acquisition If you are not acquiring land, • Respond “Not applicable” to questions 1-5 and proceed to Development- Redevelopment questions 6-9. • Any responses provided to questions 1-5 will not be reviewed or scored. 1. Is the proposed project located in an area lacking near-home recreation opportunities, including both densely settled urban areas and the surrounding rapidly growing areas, and regional population centers located throughout rural Minnesota? Not applicable 2. Does the proposed project accelerate the acquisition of private in-holdings and add lands to existing parks to enhance resource protection and recreational opportunities? Please describe. Not applicable 3. Does the proposed project accelerate the acquisition of private inholdings and add lands to existing parks to enhance resource protection and recreational opportunities? Please describe. Not applicable 4. Does the proposed project preserve high-quality natural resources? (such as ecological subsections not represented in the state park system or other comparable land holdings; exceptional one-time opportunities of unique, high-quality natural resources that meet critical needs near population centers; important water resources including lakes, rivers, wetlands, shoreline and critical watersheds; corridors that connect other protected high-quality natural resources areas)? Please describe. Not applicable November 2022 Development/Redevelopment 5. How does the proposed project develop and/or redevelop facilities that meet the differing outdoor recreation needs for people of all abilities? Does your project incorporate universal design, family friendly facilities, separation of uses (active/passive use, RV/tent sites), and an appropriate quality natural setting for proposed activities? Please describe. Not applicable per instructions above, which indicate to answer “Not applicable” if the project isn’t acquiring land. This feels like a question we should be answering, so please let us know if you would like a response. 6. How does the proposed project create an accessible environment that is open and flexible to accommodate new and emerging nature-based recreation uses? Does the project support numerous activities, maintain large open play areas, incorporate emerging nature-based activities such as camping, fishing, water access, birding, hiking, wildlife viewing, etc.? Please describe. The proposed project creates an open, flexible environment that supports a wide range of nature-based recreation by transforming an underutilized ball field into a restored, habitat-rich landscape. The site plan reintroduces native trees, shrubs, and perennial plantings—part of an award-winning landscape design recognized by America in Bloom with a $25,000 grant—while preserving open lawn areas for unstructured play and community use. This balance of open space and ecological restoration allows the park to accommodate evolving recreation trends, from active family play to informal gathering, nature exploration, and outdoor learning. The site’s location within the St. Croix River Valley—a major migratory corridor for over 300 bird species—creates strong potential for birding, wildlife observation, and quiet nature-based recreation. Proximity to William O’Brien State Park, where numerous Species of Greatest Conservation Need have been documented, highlights the strength of the surrounding habitat and the likelihood of similar wildlife viewing opportunities at the site. The new wetland trail will meander through areas of dense forest, prairie, and across the wetland via a boardwalk, allowing visitors to experience these environments up close and gain a deeper understanding of wetland ecology. Visitors to the site can expect to observe a wide variety of wildlife—including herons, sandhill cranes, swans, and birds of prey—as well as white tailed deer, muskrats, rabbits, squirrels, and the occasional fox. Together, these features support walking, birding, and environmental exploration, creating a flexible, immersive outdoor experience that evolves with seasonal patterns and user interests. 7. How does the proposed project develop infrastructure and amenities that meet a broad spectrum of community needs and interests and consider future generations (e.g., develop group-based opportunities such as group campsites, group picnic areas, and gathering spaces used by all communities; offers amenities that meet the lifestyles of November 2022 our target markets such as wireless internet, playgrounds, family bathrooms, areas for specialized interest, etc.)? Please describe. The proposed project contributes to a comprehensive recreational hub designed to serve a broad spectrum of community needs while positioning Scandia as a welcoming destination along the Gateway Trail corridor. At its core, the project strengthens both physical and social connections between key community assets, including Gammelgården Museum, the Scandia Community Center, and the future WATER TOWER BARN SCANDIA arts and heritage center. By linking these destinations through accessible trails and shared spaces, the project creates a unified environment that supports everyday use as well as larger gatherings and events. The Water Garden Play Area is part of a coordinated set of amenities that support diverse interests and group- based use, including an outdoor amphitheater for performances and cultural programming, open lawn areas for informal recreation, trail connections for walking and biking, and a wetland boardwalk that supports nature-based exploration. Additional amenities further expand the site’s ability to serve a wide range of users and evolving recreation preferences. These include widespread WiFi access across the site (donated by Midco), a seasonal café adjacent to the splash pad, accessible restroom facilities, and convenient access via trail to nearby playgrounds, tennis courts, and pickleball courts. Together, these features support multi-generational use—from children and families to older adults—and accommodate group activities such as school field trips, community festivals, and outdoor classes. By integrating flexible gathering spaces, modern amenities, and nature-based experiences, the project is designed to meet current community needs while remaining adaptable for future generations, fostering ongoing connection, learning, and shared public life. 8. Will the proposed project be designed and constructed with sustainable and resilient infrastructure, including effective storm water management (e.g., rely on up-to-date green infrastructure and best practice designs, is energy efficient, easy to maintain and uses recycled/recyclable materials, conserve the use of water at facilities and/or design facilities to effectively manage storm water onsite.)? Please describe. The proposed project is designed with sustainable, resilient infrastructure that prioritizes effective stormwater management, water conservation, and long-term environmental stewardship. The splash pad will utilize fresh water with a non- recirculating system integrated into a nature-based water management approach. Water from the play area will flow into a secondary children’s play stream and then be directed to a stormwater retention area and rain garden, where it is naturally filtered before entering adjacent wetlands. This system supports groundwater recharge while protecting water quality. The splash pad will operate with push-button, timed activation to ensure water is used only during active play, reducing unnecessary consumption and supporting efficient resource use. In collaboration with the Carnelian-Marine-St. Croix Watershed District, the project’s civil engineer developed best-practice design strategies to protect the sensitive November 2022 wetlands surrounding the site. Native plantings and rain gardens will filter both stormwater and play water, while durable, low-maintenance materials are selected to ensure long-term performance and reduced lifecycle costs. Interpretive signage will further enhance the project by educating visitors native landscapes and the role of wetlands in water filtration and ecosystem health. Together, these elements create a sustainable, resilient system that manages water responsibly on-site while fostering environmental awareness and stewardship. 9. Does the park design take into consideration emergency preparedness and resilience to changing environments (i.e. flooding events, floodplain changes, shade and water availability, plant adaptivity, and invasive species management)? Please describe. The proposed project is designed to respond thoughtfully to environmental variability, particularly given its setting within a wetland-rich landscape. The site plan works with natural systems rather than against them—slowing, filtering, and directing water through planted areas that help reduce downstream impacts during heavy rain events. These features, developed in coordination with watershed experts, allow the site to better absorb and manage changing precipitation patterns while protecting adjacent natural resources. Construction materials and site layout are selected to perform reliably through seasonal changes, reducing long-term maintenance needs and supporting consistent use over time. The project also anticipates changing conditions related to heat, vegetation, and long- term landscape health. Tree canopy, planted areas, and access to water-based play create a more comfortable environment during warmer conditions, while the landscape design prioritizes hardy, regionally appropriate plantings that can thrive with minimal intervention. Over time, these plant communities will help stabilize soils, support habitat, and reduce susceptibility to invasive species. By combining flexible design with durable infrastructure and climate-responsive landscaping, the project creates a park environment that can adapt to evolving conditions while continuing to serve the community safely and effectively. Does the Project Take Care of What We Have? 1. Does the proposed project result in redevelopment, renovation, or rehabilitation of existing infrastructure to ensure high-quality and safe experiences for the public (e.g., roof replacement, structural replacement, trail resurfacing, refurbishing trail head amenities, campgrounds rehabbed and updated, bring facilities up to modern codes and standards, and/or make it easy for everyone to access and enjoy parks and trails)? Please describe. While the Water Garden Play Area itself is a new recreational asset, it is part of a broader redevelopment of an existing public site that enhances safety, usability, and overall visitor experience. The project transforms an underutilized ball field into a vibrant, multi-functional recreational space designed to meet modern standards for accessibility, safety, and durability. New infrastructure—including accessible walkways, updated site circulation, and thoughtfully integrated amenities—will improve how November 2022 visitors move through and experience the park, making it easier for people of all ages and abilities to access and enjoy the space. The project is also closely tied to the rehabilitation of the historic WATER TOWER BARN SCANDIA tankhouse and windmill, which was carefully dismantled in 2014 and is being reconstructed as part of the larger arts and heritage center development. Together, these efforts represent a comprehensive reinvestment in a long-standing community asset—upgrading the site to support contemporary recreation needs while preserving Scandia’s historic character. By replacing outdated or underutilized infrastructure with modern, inclusive, and safe facilities, the project ensures a high-quality public experience for current users and future generations. 2. Does the project sponsor maintain a Capital Asset Management plan, that includes a schedule of replacing park equipment/facilities, to ensure protection and full utilization of the proposed facilities (yes or no, describe)? Yes. The City of Scandia maintains a capital asset management approach for its park system, including routine maintenance, repair, and long-term planning for the replacement of park facilities. This project will be supported through a collaborative management model in which Scandia Heritage Alliance provides ongoing programming, site activation, and day-to-day stewardship via a lease, while the City retains ownership and oversight. This partnership strengthens long-term sustainability by combining municipal capital planning with dedicated on-site management, ensuring the facility is actively maintained, well-utilized, and responsive to community needs over time. 3. Does the proposed project preserve existing high-quality natural areas and water resources? Please describe. The project is located within an existing park footprint and is carefully designed to preserve and enhance high-quality natural areas, including adjacent wetlands, forested areas, and prairie. In addition to protecting these existing features, the project will enhance the site by converting an underutilized ball field into a landscaped area with diverse native trees, shrubs, and perennial plantings. Rather than altering natural systems, the design works within the landscape to strengthen ecological function and biodiversity. In partnership with the Carnelian-Marine-St. Croix Watershed District, the project incorporates nature-based water management strategies that capture, slow, and filter runoff before it reaches the wetlands, improving water quality and reducing environmental impacts over time. These features not only safeguard the site’s natural systems but also elevate the overall recreation experience. Rain gardens, native prairie plantings, and surrounding forest and wetland habitats will support wildlife while creating opportunities for visitors to engage with a variety of landscapes. Interpretive signage will further enhance this experience by helping visitors understand how wetlands, forests, and prairie systems function together to support habitat, filter water, and sustain healthy ecosystems. By integrating environmental stewardship with recreation and education, the project November 2022 preserves and improves the site’s natural character while strengthening long-term resource protection and public awareness. 4. Does the proposed project restore and reconstruct natural communities that have been degraded or lost due to invasive species, agriculture, or development? While the proposed project is not a large-scale ecological restoration effort, it contributes meaningfully to the improvement and re-establishment of native plant communities within the site. The project will convert an underutilized ball field into a landscaped area featuring native trees, shrubs, and perennial plantings, replacing turf- dominated space with more diverse and ecologically beneficial vegetation. Currently, stormwater flows across the limestone infield and turf outfield directly into the adjacent wetland to the south; the proposed design will improve water quality by incorporating an engineered system that captures and directs runoff to a stormwater retention pond and rain garden, where it is filtered before entering the wetlands. The rain garden will be planted with native forbs and shrubs that support pollinators and provide forage for migratory species. The project also emphasizes long-term ecological health by prioritizing native species and avoiding the introduction of invasive plantings. These improvements enhance habitat quality, support biodiversity, and strengthen the site’s connection to the surrounding wetland, forest, and prairie systems. While additional restoration efforts may be pursued in the future, this project establishes a strong foundation for ongoing habitat enhancement and responsible land stewardship. November 2022 ITEM 4 - COST BREAKDOWN Development (see Program Manual for eligible costs). Contingency and indirect costs are not eligible grant expenditures. Design/Engineering costs more than 10% of the total project construction cost are not eligible. Be aware we require all existing and proposed facilities to have accessible routes so please account for that in your cost breakdown. If your project is selected for federal funding, the Build America, Buy America Act will apply (BABAA). We recommend including pricing from BABAA compliant companies to the extent possible on applicable budget lines. Pursuant to Minnesota Statutes 177.41 to 177.44, and corresponding Minnesota Rules 5200.1000 to 5200.1120, this program is subject to prevailing wages as established by the Minnesota Department of Labor and Industry. If awarded, all contractors and subcontractors must pay all laborers and mechanics the established prevailing wages for work performed under the contract. Failure to comply may result in civil or criminal penalties. Accordingly, ensure pricing includes costs for prevailing wages. Please provide cost breakdown by facility, not by materials. See examples. Delete the listed examples from your budget prior to submission. Please reference the Outdoor Recreation Budget Template for additional guidance. You can utilize the table below or budget template to complete your project budget. Facility (e.g., picnic area, campground, walkway, shelter, restroom) Description (linear feet, dimensions, material used, number of components, etc.) Cost Per Unit Total Cost Land, Structures, rights-of-way, etc. Site work Demotion and removal Construction Example: Bathroom/Shower/Storm Shelter Materials and labor for construction of one 37’ x 38’ concrete block facility. Also includes septic system and drain field. $596,000 $596,000 Ex: ADA-Compliant Pathways X,XXX linear feet; Kafka Granite Stabilized Pathway Mix (8’ ft width) $36,252 $36,252 Equipment Playground equipment & surfacing 7 main play pieces (including 3 ground components), 7,850 SF engineered wood fiber $215,000 $215,000 Miscellaneous Ex: Signage Installation and maintenance of 1 interpretive and 3 directional signs $950 $950 Grand Total 1. How were the cost estimates derived? November 2022 We obtained initial splash pad estimates from four playground companies representing four different manufacturers of splash pad components (Waterplay, Raindeck, Water Odyssey, and Aquatix). Once we selected Waterplay as the preferred manufacturer due to the high quality and long-lasting nature of its products, the splashpad installation was competitively bid via Sourcewell. For the children’s play stream and the accessible walkways, we obtained estimates from three landscape companies. The estimates for the picnic tables and shade structure are based on an online search from a variety of manufacturers, with input from our landscape architect on the quality of various systems reviewed. 2. What assurances are there that the costs listed are reasonable? All costs listed are based on competitive bids from at least three companies for each component of the project. 3. Describe any project elements or costs that will improve site resiliency and facility longevity, if any. The project team has selected Waterplay splash pad components based on their proven durability, high-quality materials, and long-term value in municipal park settings. Waterplay is widely regarded as a top-tier, municipal-grade manufacturer, with more than 30 years of experience and thousands of installations worldwide in public parks, resorts, and large-scale recreation facilities. Their systems are engineered for heavy use and long-term performance, utilizing robust materials such as stainless steel and aluminum that can withstand demanding conditions, including Minnesota’s freeze-thaw cycles. Manufacturer warranties further reflect this durability, with stainless steel piping and weldments covered for 25 years, aluminum components for 10 years, and key play elements such as nozzles covered for 5 years. In addition, the splash pad will be constructed on a Bomanite Sandscape concrete base, a high-quality, slip-resistant surface known for its long-lasting durability, low maintenance requirements, and comfort for barefoot use. By selecting infrastructure-grade equipment and materials—rather than typical playground-grade components—the project prioritizes longevity, safety, and lifecycle value. Waterplay’s modular system allows for efficient maintenance and replacement of individual parts over time, reducing long-term costs while maintaining high-quality performance. The use of durable concrete surfacing further enhances site resilience by withstanding heavy use and environmental exposure. Together, these investments in proven, long-lasting materials ensure the splash pad will remain a reliable, engaging, and well-maintained community asset for decades to come. 4. What is the anticipated life span of the facilities that will be funded as part of this project? What are the estimated annual maintenance costs? The anticipated lifespan of the splash pad is approximately 25–30 years, based on the use of high-quality, municipal-grade components designed for long-term durability and November 2022 heavy public use. Key structural elements, including stainless steel features and underground infrastructure, are expected to perform reliably over multiple decades, while individual components such as nozzles and activation features can be replaced as needed to extend the overall life of the system. Estimated annual maintenance and operating costs are modest and include the following: Seasonal start-up and winterization: approximately $1,000 annually (system blow-out and shut-down); Routine maintenance, including periodic inspection, cleaning of nozzles, and minor repairs: $500 - $3,000 annually; Utilities: $500 annually (limited to electricity for system operation because water is supplied via the on-site well); Insurance: $3,000 annually (insurance costs are lower for fresh-water splash pads, and this feature will only be open from approximately Memorial Day through Labor Day). 5. What is your recent experience completing similar projects with state or federal grant funding? The City of Scandia has worked with Conservation Partners Legacy grant funding for improvements to the natural habitat of Lilleskogen Park and obtained a previous DNR Recreation grant for installation of a playground near City Hall. The Lilleskogen Park project included removal of invasive species; buckthorn, canary reed grass, and wild mustard. The project also included the addition of a nature trail, butterfly garden, and rain garden. The City Hall playground project included playground equipment and installation of an approximately 500 square foot rain garden with native forbes and grasses. Additionally, the City of Scandia has obtained LCCMR grants (Minnesota Environmental Trust Fund) to build the wetland trail discussed in this application, as well as the Gateway Trail segment through Scandia. Both of these projects have been designed and bid, but construction has not yet commenced. Land Acquisition (if application includes acquisition) – Federal (Yellow-Book) Appraisal(s) must be attached. If you are not acquiring land, any answers provided here will not be reviewed or scored. Parcel Identification Number or location Description of property Acres Appraised Value Not applicable Grand Total 1. Why is this acquisition needed? Not applicable 2. Describe the existing resources and features of the site that make it desirable for public outdoor recreation. Not applicable November 2022 3. Explain how you envision this acquisition contributing to outdoor recreation in the long term. Not applicable 4. From whom is this property being purchased? Not applicable 5. Are any buildings or structures being purchased along with the property? a. ☐ No b. ☐ Yes – Describe what is planned for those structures and whether the grant funded project includes the value of those structures. Not applicable 6. How and when will the site be made open and accessible for public outdoor recreation use? For acquisition only grants, parking and a funding acknowledgement sign must be posted prior to close of the grant and the park open for public access. Recreation facilities must be developed within three years from the date of acquisition. Not applicable 7. Is this property being acquired under threat of condemnation? Not applicable 8. Was the property listed for public sale? a. ☐ No b. ☐ Yes – Explain how the property owner was made aware of the grant sponsor’s interest in the property. Not applicable 9. Does this project involve donated property? a. ☐ No b. ☐ Yes – Include evidence that the seller was offered the fair market value of the property as just compensation and willingly chose to donate the property instead. Not applicable November 2022 ITEM 5 - PROJECT SITE EVALUATION All applicants must prepare and submit the Project Site Evaluation on the next pages. The project site evaluation will provide information necessary to determine the impacts of the project, if any, on the environmental and cultural resources of the project area. It is very important that the project site evaluation identify all possible impacts of the proposed project. This will help determine whether any changes in project scope or design may be required or whether mitigation measures must be undertaken. Use the resources below to help you fill out the evaluation: Endangered Species and Critical Habitat Resources US Fish and Wildlife Service (USFWS) Information for Planning and Consultation (IPaC) Report provides a list of species and other resources such as critical habitat (collectively referred to as trust resources) under the USFWS’ jurisdiction that are known or expected to be in or near the project area. The list may also include trust resources that occur outside of the project area, but that could potentially be directly or indirectly affected by activities in the project area. However, determining the likelihood and extent of effects a project may have on trust resources typically requires gathering additional site-specific (e.g., vegetation/species surveys) and project-specific (e.g., magnitude and timing of proposed activities) information. Minnesota’s List of Endangered and Threatened Animal Species Additional information on animals and plants that are endangered, threatened or merit special consideration or management is available from the Minnesota Natural Heritage Program/Nongame Wildlife Program, Section of Wildlife, Department of Natural Resources (DNR). Minnesota’s List of Endangered and Threatened Animal Species, identifying all species of Minnesota's animals and plants listed under the provisions of the Federal Endangered Species Act of 1973, Public Law 93-205, and/or Minnesota Statute 84.0895, is available online, or from the DNR by calling (651) 296-6157 or (888) 646-6367, or via the DNR website Minnesota's Endangered, Threatened, and Special Concern Species. Additional information may be obtained by calling the Division of Ecological Resources information number at (651) 259-5100. The DNR is also developing biological surveys on a county-by-county basis on sensitive natural habitats and rare plant and animal species. Several publications are available which provide detailed information on these subjects. Additional information about county biological surveys is available at Minnesota Biological Survey. Wetlands Resources Minnesota has adopted a "no-net-loss" wetlands policy. Each state agency must ensure that its activities, including state sponsored, financed, or assisted projects, do not contribute to the loss or diminishment of the many important values of wetlands. Unavoidable impacts must be minimized, and compensatory mitigation must be provided for all values that have been lost or diminished. The basic reference for wetland determination will be the National Wetlands Inventory produced by the U. S. Fish and Wildlife Service and available at the DNR. Questions regarding implementation of the "no-net-loss" policy and identification of wetlands may be directed to the Ecological Resources Division, DNR at (651) 259-5100. November 2022 Project Site Evaluation Using the following format and subject categories below, address all of the points covered under each category and be specific. It is important that the project site evaluation be a complete and accurate assessment of the natural and/or scenic characteristics of the area and the likely impacts of the project, either positive or negative, on those characteristics. Part 1 – USFWS Information for Planning and Consultation (IPaC) Report Review of your project by the US Fish and Wildlife Service (USFWS) Information for Planning and Consultation (IPaC) Report is required to provide a list of species and other resources such as critical habitat (collectively referred to as trust resources) under the USFWS’ jurisdiction that are known or expected to be in or near the project area, as well as a determination of the project’s impact on the list of species and other resources (consistency letter). The list may also include trust resources that occur outside of the project area, but that could potentially be directly or indirectly affected by activities in the project area. However, determining the likelihood and extent of effects a project may have on trust resources typically requires gathering additional site-specific (e.g., vegetation/species surveys) and project-specific (e.g., magnitude and timing of proposed activities) information. From the website, click on “Get Started” then enter a location, define the area, and confirm the area where the project activities will occur. Then click on “Continue,” print the resource list and attach to your application. Next, follow the IPaC Determination Key guidance to receive a determination for each listed species and resource and attach the consistency letter to your application. Use this information to help guide your responses below. Part 2 – Minnesota Conservation Explorer Conservation Planning Report A Conservation Planning report (free of charge) is required to provide information on ecologically significant areas. Go to: Minnesota Conservation Explorer (MCE) (found at https://mce.dnr.state.mn.us/)  Click on EXPLORE Tab o Define Area of Interest (draw, select layers, or upload shapefile) o Ensure the defined area covers both the entire project area plus any potentially impacted areas.  Click on “CONSERVATION PLANNING REPORT” o The report may take several minutes to generate.  Save and attach to your grant application.  Use this information to guide your responses below. If your application is funded, the DNR will require you to request and submit a Natural Heritage Review letter. There is a fee to conduct this step. Please do not conduct a Natural Heritage Review unless you have been selected for funding. The cost of this review is not an eligible grant expense. November 2022 Part 3 – Minnesota State Historic Preservation Office (SHPO) – Initial Data Search SHPO research request procedures have changed with the launch of the Minnesota Statewide Historic Inventory Portal (MnSHIP). Please visit MnSHIP (https://mnship.gisdata.mn.gov/) and the Office of the State Archaeologist (OSA) OSA Portal (https://osaportal.gisdata.mn.gov/) to perform research yourself. You can also visit https://npgallery.nps.gov/nrhp to obtain National Register of Historic Places nominations and information. Although this process allows for quick turnaround of results, please allow sufficient time in case follow-up with Minnesota Indian Affairs Council (MIAC) and/or OSA as needed. At MnSHIP, search for the project area by 1) address; 2) township, section, and range; or 3) Shapefile. Once you have located your project area, draw a box to further specify the project area, select the print option on the right-hand side of the map, enter a title and export. This will provide a map with a legend and scale. Attach the map to your application. At the OSA Portal, search for your project area. Once located, draw an area to further specify your project area and save a screenshot. Attach the screenshot to your application. If the MIAC layer shows up in your project area, you will need to reach out to MIAC and OSA to see if there is potential impact to a cemetery. Reach out to the Grant Coordinators for guidance if this is required. Email communication to MIAC and OSA must be attached to the application. Use the information from MnSHIP and OSA Portal and your community history to help guide your responses below. November 2022 Part 4 - Description of Environment and Environmental Impact of Proposed Project A. Present Land Use: Describe the existing site conditions, facilities, and park acres. The existing site has been maintained as a ball field. It has a limestone infield surface, a turf outfield area, and gravel parking lot. The City is not actively maintaining the site during the transition to WATER TOWER BARN SCANDIA arts and heritage center. The park size is about 6 acres. 1. Explain why the site is suitable for the type of outdoor recreation proposal being submitted. The Water Garden Play Area is highly suitable for the proposed outdoor recreation project due to its central location within the City of Scandia and its proximity to key community destinations, including the Community Center/City Hall and Gammelgården Museum. These are well-established gathering areas, hosting annual and seasonal events such as Taco Daze, Vinterfest, and a weekly Farmers Market from June through September. These existing uses demonstrate consistent public activity and make the site an ideal location to expand recreational and cultural opportunities. The addition of the Water Garden Play Area will build on this established use by providing a dedicated, family-friendly outdoor recreation amenity that encourages longer visits and repeat use, complementing two small playgrounds nearby. The site’s layout allows for integration with existing and planned trails, open space, and gathering areas, creating a cohesive park experience. Existing infrastructure, including parking access, supports efficient development and long-term maintenance. Planned ADA-accessible pathways will further enhance usability, ensuring the site can be safely and comfortably accessed by individuals of all ages and abilities. Together, these factors make the site a logical and effective location for expanded outdoor recreation investment. 2. Does the site include any elements that visually detract from the outdoor recreation experience or that represent a potential public safety hazard? a. ☒ No b. ☐ Yes – Explain and describe whether this project will help to address those concerns. Not applicable B. Environmental Intrusions: Describe all rights-of-way, easements, reversionary interests, etc. within the proposed boundary area. All existing and future overhead power lines serving the park must be placed underground. The cost of placing the power lines underground can be included in this application. There currently is no power to the park and it will be brought onto the site as part of constructing the WATER TOWER BARN SCANDIA arts and heritage center. All lines will be underground. Utility and Right-of-Way easements are located along County Road 3 (also known as Olinda Trail), which borders the site’s parking lot. November 2022 C. Fish and Wildlife: Indicate whether the proposed project site is on or adjacent to a national, state, or local wildlife management area, park, or natural area. Describe the known fish and wildlife species common to the project site and any known species that are listed as endangered, threatened or of special concern. Describe the likely impacts of the proposed project on habitat, population levels, and any other factors related to the fish and wildlife resources. The proposed project site is located within a developed municipal park in a rural setting and is not within or directly adjacent to a designated national, state, or local wildlife management area. However, the surrounding landscape includes wooded areas, open grassland, and nearby wetlands that support regional wildlife. According to the U.S. Fish and Wildlife Service IPaC report, species that may occur in the broader project area include the endangered northern long-eared bat, whooping crane (experimental population), several federally listed freshwater mussels, and insects such as the monarch butterfly and western regal fritillary. Bald eagles and migratory bird species of conservation concern, including wood thrush, cerulean warbler, and bobolink, may also be present seasonally. The project site itself consists of previously disturbed turf and does not provide suitable habitat for most listed species, with no known critical habitat within the project footprint. Impacts to fish and wildlife resources are expected to be minimal. Construction will occur within an already disturbed area, resulting in negligible habitat loss, with only temporary disturbance from noise and activity. No impacts to federally listed species or critical habitat are anticipated. Existing tree cover and natural areas outside the project footprint will be preserved, and best practices will be followed to minimize disturbance to migratory birds and other wildlife, including consideration of construction timing where feasible. Over time, the project may provide localized benefits through improved site management and reduced informal disturbance, resulting in negligible to minor overall impacts to fish and wildlife resources. D. Vegetation: Describe the major plant species and communities common to the project site and any known species that are listed as endangered, threatened or of special concern. Describe the distribution of major plant communities or types on the site. Indicate the extent of cutting, clearing, removal or other disturbance that will result from the proposed project, as well as any restoration and/or protection activities planned as part of the project. The project site consists primarily of a previously developed ball field, including a limestone gravel infield and turf grass outfield, with naturally occurring forest along the overall site perimeter. The surrounding forest has been identified by Washington Conservation District consultants as southern dry-mesic oak (maple) woodland (FDs37), a native plant community type common to the region. The broader landscape reflects a mix of managed open space and deciduous woodland typical of community park settings. A review of the Minnesota Department of Natural Resources Conservation Explorer database identified no rare plants, native plant communities within the project footprint, or ecologically significant vegetation features within the project area or buffer. November 2022 Vegetation impacts will be limited to the removal of existing turf within the ball field outfield and minor disturbance during construction, with no impacts to the surrounding woodland community. The project includes restoration and enhancement measures that will improve site conditions over time, including the installation of rain gardens and the introduction of native trees, shrubs, and perennial plantings. These improvements will increase plant diversity, support pollinators, and enhance habitat value while stabilizing soils and reducing runoff. Overall, the project replaces low-diversity turf with more ecologically beneficial vegetation, resulting in a net positive impact on site vegetation. E. Wetland Resources: Describe any existing wetland areas on or adjacent to the proposed project site. Indicate any likely physical disturbances of these wetlands, including (but not limited to) draining and filling that would result from the proposed project. Describe any other potential impacts to wetlands, such as water level fluctuations or water pollution that may result from the proposed project. Discuss possible alternatives that would avoid or minimize negative wetland impacts. Also describe any other water resources on or adjacent to the site, proposed uses of surface or groundwater, and any possible impacts on these resources, including depletion or pollution, resulting from the proposed project. Explain how the proposed project would help to protect water quality on or adjacent to the site. The proposed project is located within a developed park area and is not situated within a mapped wetland, though a high-quality wetland exists adjacent to (south of ) the proposed Water Garden Play Area. No direct impacts to wetlands are proposed, including no filling, draining, or alteration of wetland areas. The project has been intentionally designed to avoid disturbance by maintaining appropriate setbacks and minimizing the development footprint. In contrast to existing conditions—where stormwater from the current ball field flows directly into adjacent wetlands — the proposed design improves water quality by incorporating engineered stormwater management systems that capture, slow, and filter runoff before it enters natural areas. Erosion and sediment control measures will be implemented during construction to further protect nearby resources. The project will utilize groundwater from a dedicated on-site well, designed with a 4- inch pipe and expected to draw from the Prairie du Chien Group or underlying Jordan Sandstone aquifer. Water use will be limited, seasonal, and controlled through a push- button activation system that operates only during active play. As a freshwater system, the splash pad will not use chemical treatments, eliminating the risk of contaminated discharge. Water from the splash pad will flow through a nature-based play stream and into a stormwater retention pond and rain garden, where it will be naturally filtered and infiltrated, supporting groundwater recharge while protecting water quality. Consultation with a local hydrogeologist confirms that the limited use of this well will not adversely impact the aquifer, surrounding resources, or other users. The project has been developed in coordination with the Carnelian-Marine-St. Croix Watershed District and Washington Conservation District to ensure best practices are followed. Overall, the project avoids wetland impacts while enhancing water management and protecting both surface and groundwater resources. November 2022 F. Geologic and Physiographic Features: Describe any interesting, unique, or fragile geologic and/or physiographic features on the proposed project site and any likely impacts on these features that would result from the proposed project. Also describe any proposed protection activities or measures to provide public education, interpretation, and enjoyment of these resources. The project site consists of relatively flat to gently sloping terrain typical of developed parkland in the region. No unique, rare, or fragile geologic or physiographic features have been identified within the splash pad project area. The site has been previously disturbed and is currently maintained as a ball field, with no significant landforms or geologic features present that would be affected by development. Project impacts to geologic and physiographic features will be minimal and limited to minor grading necessary for splash pad installation. No significant alteration of existing landforms is anticipated. Standard erosion and sediment control measures will be implemented during construction to protect soil stability and prevent runoff. While the project does not directly interpret geologic features, it enhances public understanding of the site’s natural systems through nearby boardwalk trails and interpretive signage focused on wetlands, water movement, and landscape processes, supporting education and appreciation of the broader environment. G. Flood plains: Describe any flood plains in the project area. Include flood plain levels, what development in the flood plain areas will look like and all mitigation efforts. Based on available mapping and site context, the project area is not located within a designated floodplain. No floodplain development is proposed, and the project will not alter flood storage or conveyance. H. Air Quality/Noise: Describe any temporary or permanent air or noise pollution that will result from the development and use of the site and the impact(s) on adjacent land uses or landowners. Construction Phase: Temporary increases in noise, dust, and equipment emissions. Adjacent uses are primarily commercial in a low-density commercial district. The two adjacent homeowners are shielded by forest and will be minimally impacted. Construction will not block streets or sidewalks; will occur during standard daytime hours; and dust-control measures will be implemented as needed. Operational Phase: Minimal impacts typical of park-use noise (children playing, water features). No significant effect is expected on adjacent landowners. I. Archaeology/ Ground Disturbances: Provide a description of current and historic land use and ground disturbances. Include available information concerning known or suspected archaeological resources within or adjacent to the park. Indicate if any of these identified resources will be impacted by the proposed project. The project site is located within an existing community park and has been previously disturbed through grading, installation of recreational infrastructure (including fencing and bleachers), and ongoing maintenance. Review of the Minnesota State Archaeologist (OSA) Portal and MnSHIP mapping indicates no known archaeological sites or burial features within the project area and no identified correlation with Minnesota Indian Affairs Council (MIAC) sites. One documented archaeological site associated with November 2022 Gammelgården Museum is located across the street from the project site; however, it is outside the project area and will not be impacted by the proposed development. Ground disturbance associated with the project will be limited to a small, previously altered footprint, and no known archaeological resources will be affected. As a precaution, the project will follow standard protocols during construction: if any artifacts or cultural materials are encountered, work will cease immediately and appropriate authorities will be notified in accordance with state guidelines. These measures ensure that any unexpected resources are properly identified and protected. J. Historic Structures: List known historic buildings or structures located within or adjacent to the project area (i.e., individual properties or districts which are listed in the National Register of Historic Places, or which meet the criteria for listing in the National Register). If applicable, identify any expected or potential impacts to these properties with the proposed project. Review of MnSHIP and National Register resources indicates no historic properties or structures listed on the project site. Per 2022 correspondence between the City of Scandia and DataRequestSHPO, the historic sites adjacent to the site are: Elim Lutheran Church, Elim Pastor House, Elim Cemetery, and Gammelgarden Museum. Historic structures adjacent to the project site will not be impacted by the splash pad and new amenities. K. Surveys: Have there been any previous cultural and/or historic resource surveys completed that included this project site within the area of potential effect that was assessed? ☒ No – Describe any construction planned as a result of this project that will extend beyond the pre-existing disturbance area (including surface area and depth). The project will involve construction within a previously disturbed park area. Ground disturbance will be limited in both surface area (approximately the splash pad and children’s play stream footprint) and depth (limited to standard excavation for utilities and base preparation). No expansion into undisturbed natural areas is proposed as part of this specific project. ☐ Yes – Attach survey and summarize findings and include page number references below. Not applicable November 2022 Part 5 - Environmental Screening Form (ESF) The table below serves as a record of the environmental resources present at the site, whether the proposed action is likely to have a significantly negative impact on those resources, and whether further information is needed to determine the potential impact. Review the listed resources and identify any resources that may be significantly impacted by the action. The Environmental Screening Form (ESF) should be completed with professional input from resource experts and in consultation with relevant local, state, tribal, and federal governments, as appropriate. For each resource, indicate if positive or negative impacts are anticipated to result from the action or if further information is needed to determine the potential impact. Site Name: Resources + - No Impact Not Present Unknown 1 Air quality ☐ ☐ ☒ ☐ ☐ 2 Circulation and transportation ☐ ☐ ☒ ☐ ☐ 3 Climate ☐ ☐ ☒ ☐ ☐ 4 Contamination or hazardous materials even if remediated ☐ ☐ ☐ ☒ ☐ 5 Endangered species: (listed or proposed threatened or endangered) including associated habitat ☒ ☐ ☐ ☐ ☐ 6 Geological resources: soils, bedrock, slopes, streambeds, landforms, etc. ☐ ☐ ☒ ☐ ☐ 7 Historic or cultural resources ☒ ☐ ☐ ☐ ☐ 8 Invasive species ☐ ☐ ☒ ☐ ☐ 9 Land use plans or policies from other agencies including tribes ☐ ☐ ☒ ☐ ☐ 10 Lightscapes, especially night sky ☐ ☐ ☒ ☐ ☐ 11 Migratory birds and/or Bald and Golden Eagles ☒ ☐ ☐ ☐ ☐ 12 Recreation resources ☒ ☐ ☐ ☐ ☐ 13 Socioeconomics: changes to tax base or competition with private sector ☐ ☐ ☒ ☐ ☐ 14 Sound (noise impacts) ☐ ☐ ☒ ☐ ☐ 15 Unique ecosystems, such as biosphere reserves, World Heritage sites, old growth forests, etc. ☐ ☐ ☒ ☐ ☐ 16 Water quality and/or quantity ☒ ☐ ☐ ☐ ☐ + indicates positive impacts are anticipated to result from the action - indicates negative impacts are anticipated to result from the action No Impact Not Present indicates the project will have an insignificant impact positive or negative indicates the resource does not exist on site Unknown indicates more research is needed to determine impacts (May indicate the need for an Environmental Assessment) November 2022 17 Water: coastal barrier resources or coastal zones ☐ ☐ ☐ ☒ ☐ 18 Water: marine and/or estuarine ☐ ☐ ☒ ☐ ☐ 19 Water: stream flow characteristics ☐ ☐ ☒ ☐ ☐ 20 Water: wetlands and floodplains ☒ ☐ ☐ ☐ ☐ 21 Other important resources Explain: ☐ ☐ ☐ ☒ ☐ 1. Have there been any previous environmental documents that are relevant to this project or this specific site? a. ☒ No b. ☐ Yes – Attach and summarize findings and include page number references below 2. Explain any negative or unknown impacts identified in the table of the ESF. Not applicable. 3. How was the information identified in the table derived and what sources of data were used to justify the impact selection? Impact determinations were based on a combination of site-specific observations, project design plans, and review of available environmental data sources. These included the Minnesota Department of Natural Resources Conservation Explorer Planning Report, MnSHIP mapping, the Minnesota State Archaeologist (OSA) Portal, and the U.S. Fish and Wildlife Service IPaC report. Together, these sources provided information on existing natural resources, habitat conditions, and the presence or absence of sensitive features within and adjacent to the project area. The project scope was then evaluated in relation to these findings. Because the proposed work is located within a previously disturbed ball field and developed park setting, impacts to natural or native areas are expected to be minimal. In contrast, the introduction of improved stormwater management practices—including rain gardens and controlled runoff systems—is expected to result in positive impacts to surrounding wetlands and habitat quality. This combination of site conditions, verified data sources, and design features informed the overall impact assessment reflected in the application. 4. Who contributed to filling out the ESF (include name, title, agency) and what qualifications do they have that provide the necessary resource expertise to determine impact significance? The form was filled out by Communications Consultant Suzanne Lindgren, a board member of Scandia Heritage Alliance (SHA) and Susan Rodsjo, SHA Board Chair. Lindgren pulled all required reports needed to fill out the form, and both Lindgren and Rodsjo reviewed the reports. Responses were reviewed for accuracy by Kyle Morell, City of Scandia Administrator, and the Scandia City Council ahead of submission. The following people were consulted for answers: Washington Conservation District Landscape Restoration Specialists Elissa Thompson, Tara Kelly, and Brett Stolpestad (based on November 2022 responses from a previous DNR grant application for a related project at the site); Project Architect Peter Hilger, AIA; Project Civil Engineer Drew Messmer, PE; and Scandia-based hydrogeologist Dave Hume. 5. List all required federal, state, and local permits/approvals needed for the proposal and explain their purpose and status. City of Scandia – Grading and Building Permits: These permits will be required for site preparation, excavation, utility installation, and construction of the splash pad facility. They ensure that all work complies with local zoning, building codes, and safety standards. Status: In progress as part of the overall plans for the WATER TOWER BARN SCANDIA arts and heritage center project. Carnelian-Marine-St. Croix Watershed District Permit: A permit from the watershed district will be required to review and approve stormwater management, erosion control, and any land disturbance activities. This ensures the project protects local water resources and meets watershed standards. Status: In progress as part of the overall plans for the WATER TOWER BARN SCANDIA project. Plumbing Permit: Because plumbing is provided to the Water Garden Play Area, a plumbing permit will be required. It will be pulled by the plumber selected for the overall WATER TOWER BARN SCANDIA project. Electrical Permit: Because power is provided to the Water Garden Play Area, an electrical permit will be required. It will be pulled by the electrician selected for the overall WATER TOWER BARN SCANDIA project. NOTE: No permit is required from the Minnesota Department of Health because this is a freshwater splash pad – not considered a pool. November 2022 Part 6 – Community Information All applicants must provide the census tract data listed below for the project location.  Visit FRB Census Geocoder  Select year 2025  Type the park address into the search bar. Conduct search.  Select print icon in the “Census Demographic Data” box.  Use the Tract Information to provide the following information: Tract Information Number: 0702.05 County: Washington County Population: 3,984 Tract Demographics Race / Ethnicity White: 3,696 Black or African American: 10 American Indian and Alaska Native: 6 Asian: 23 Native Hawaiian or Pacific Islander: 0 (included in above category on Census report) Other: Included below Two or more races: 169 Hispanic: 80 1. Please provide information regarding the project location or community served. Does your target population fall outside the census tract of the project location? Are there population trends happening in your community, city, county, etc. that influence the need for or impact of your project? The project is located in Scandia, a rural community with a population of approximately 3,984 residents. The city reflects a predominantly residential, middle-income population, with a relatively low percentage of minority residents (7.23%) and median family income slightly above the regional average. While the immediate census tract is not classified as underserved or distressed, the project serves a broader regional population beyond tract boundaries. Scandia’s location at the northern terminus of the Gateway Trail and its proximity to regional destinations position it as a growing access point for visitors from across Washington County and the greater Twin Cities metropolitan area. Population and recreation trends indicate increasing demand for accessible, destination- oriented outdoor amenities. Regional trail use continues to grow, alongside rising interest in free, family-friendly recreation and nature-based experiences such as walking, biking, and environmental learning. At the same time, an aging and multi-generational population requires inclusive amenities that support a wide range of abilities and activity levels. In response, the project is designed to serve both local residents and a broader, more diverse user base, including visitors who rely on regional recreation infrastructure to access high- quality outdoor experiences. November 2022 ITEM 6 – PUBLIC PARTICIPATION AND BENEFIT Address the following questions regarding public participation, planning process and how this project will provide new and/or expanded recreational opportunities. 1. Describe both short- and long-term outdoor recreation benefits that will be achieved as a result of this project. Short-term benefits of the proposed project include the immediate expansion of outdoor recreation opportunities within the park through the addition of a splash pad, children’s play stream, plus accessible and shaded outdoor seating. Additional elements of the overall project (not part of this application) will enhance trail connections, improving access to cultural and recreational amenities. These improvements will increase park usage and provide a safe, engaging environment for children and families, while supporting both active recreation (water play, walking, biking) and passive enjoyment of the surrounding landscape. The project responds directly to community interest in accessible, family-friendly amenities and strengthens the park’s role as a central gathering space for residents and visitors. Long-term benefits are broader and more transformative. The project contributes to a growing, connected recreational network linking the Gateway Trail to key community destinations, helping establish the site as a regional destination for outdoor recreation. Over time, it will expand access to nature-based experiences—including wetlands, wildlife observation, and environmental education—while supporting community health, social connection, and overall well-being. Increased visitation is also expected to contribute to local economic vitality. The integration of interpretive elements focused on wetlands, water quality, and local history ensures the site provides lasting educational and recreational value for future generations. 2. Explain how this project fits as part of other projects planned for this same site in the next three years. The proposed project is a key component of a broader, phased vision for the WATER TOWER BARN SCANDIA site. Over the next several years, planned and ongoing efforts include construction of WATER TOWER BARN SCANDIA arts and heritage center, including the rebuilt and restored tankhouse barn, an outdoor amphitheater, an outdoor summer café/coffee shop with bistro table seating on the outdoor courtyard; indoor and outdoor WiFi access; wetland overlook decks; and interpretive signage focused on water systems, wetlands, and local history. Construction starts in 2026. Upcoming development also includes a bike and pedestrian trail network—including a wetland boardwalk connecting to the Gateway Trail extension. Expanded programming will introduce cultural events, environmental education, and performances that activate the site throughout the year. Plans for Phase 2 Construction at the site include a unique outdoor proscenium stage for theater and music performances in the amphitheater; museum displays inside the barn; and interpretation (possibly around the wetland trail) on the history and culture of Ojibwe and Dakota Peoples who lived in Scandia before November 2022 European settlement. The Water Garden Play Area complements these investments by serving as a family- oriented recreational anchor that encourages regular, daily use of the site. By attracting visitors of all ages, it helps support and sustain adjacent amenities, trails, and programming. Together, these coordinated projects will transform the site into a cohesive destination that integrates recreation, education, and cultural experiences, creating a vibrant and welcoming community gathering space. 3. Describe the process that led to the development of this proposal and how the public was involved. • Who was involved (include any state, local, and federal agency professionals, subject matter experts, Native American tribes, and members of the public)? • What information was made available and what opportunity to be involved in planning and developing your proposal was provided? • How were they able to review the completed proposal? • Describe any public meetings held and/or formal public comment periods, including dates and length of time. Were formal comments received, and did you provide written responses? The development of this proposal is the result of multi-year community planning and collaboration among the City of Scandia, Scandia Heritage Alliance, design professionals, and the public. Public engagement began in 2019 with a community meeting to explore options for reusing the historic Water Tower Barn, where residents expressed strong support for an arts and heritage center that included family-oriented amenities such as a splash pad. Following design development, the project was incorporated into a Planned Unit Development for the City Hall/Community Center site, which included a formal public hearing and opportunity for community comment. In 2024, Scandia Heritage Alliance engaged Jill Brown Public Relations to conduct focus groups and an online survey to inform future programming and amenities. A total of 395 surveys were completed, including 267 responses from local residents. Results showed strong demand for family-friendly experiences. 70% of respondents with children or grandchildren indicated they would visit a water garden play area. Community input has consistently emphasized stewardship of public funds, the need for family-oriented recreation, preservation of Scandia’s rural character, and improved connectivity between destinations. Project planning has consistently prioritized these community values, and presentations have highlighted how they are being met. In 2025, project partners began a series of public meetings to present final design plans and gather feedback. An initial open community meeting at the Scandia Community Center drew strong attendance and positive response, with project architects and planners addressing questions directly. To date, four neighborhood meetings have been held, with additional meetings planned to ensure continued engagement. While no formal public comment period was conducted specifically for this grant application, the proposal reflects extensive public input gathered through these processes and will continue to be refined through standard city review and permitting procedures. November 2022 4. If relevant, please describe in further detail any tribal engagement that has occurred on this project. No formal tribal consultation was required or conducted specifically for the splash pad project, as initial review through the Minnesota State Archaeologist and related databases did not identify known cultural or burial sites within the project area. The project site is located within a previously disturbed park setting, and no direct impacts to known tribal cultural resources are anticipated. However, Scandia Heritage Alliance is actively engaging Indigenous perspectives as part of the broader WATER TOWER BARN SCANDIA project. Through a grant from the Minnesota Historical Society, an Indigenous Partner Team—comprised of local residents with Native American heritage—is working to research and share the history and cultural significance of Dakota and Ojibwe peoples in the region. This effort is led by An Garagiola (Bois Forte Anishinaabe), a Ph.D. student at the University of Minnesota. Findings from this work will be incorporated into interpretive signage along the site’s trail system, creating opportunities for visitors to learn about Indigenous history, culture, and connection to the landscape. November 2022 ITEM 7 – AVAILABILITY FOR PUBLIC USE All facilities within the park must be designed and available for general public use and open during typical park hours. This includes restrooms, picnic shelters, campgrounds, playgrounds and other structures. For parks that include marina or campground facilities, a minimum of 50% of the berths/campground spaces must be available for short-term rental and an equitable method of allocating long-term rentals shall be used. All personal property must be removed at the end of each use season. State the specific hours of operation, including seasonal hours, and any current or anticipated programmed use for the facilities proposed to be funded with this application. Stating the park will be open during normal park hours is not specific. Also describe any arrangements with schools, local organizations, clubs, or city programs for the use of the facilities and any reservation systems. Explain how this may impact facility availability to the public. Describe what fees, if any, will be charged for use of the park facilities and/or access to the park. The outdoor park space at WATER TOWER BARN SCANDIA will be open to the general public during the following defined hours: May–September from 7 a.m. until 9 p.m., and October– April from 9 a.m. to 4 p.m. The splash pad will operate seasonally, typically from Memorial Day weekend through Labor Day, with daily hours of 7 a.m. until 9 p.m. The system will utilize push- button activation with timed operation to ensure efficient use and availability throughout the day. Exhibits inside the Water Tower Barn will be open seasonally from 10 a.m. – 4 p.m. Wednesday through Sunday, from May 1 to mid-December. The barn will be closed to the public from mid-December through May 1. The park is primarily intended for general public use. While the site may host community events, performances, and educational programming associated with WATER TOWER BARN SCANDIA and the amphitheater, these activities will be scheduled to minimize disruption and will not restrict access to core amenities, including the splash pad. No exclusive-use reservations will be allowed for the splash pad, and open lawn and gathering areas will remain available for informal use except during limited, scheduled events. No fee will be charged for general access to the park or splash pad. Fees may be associated with specific programmed events or facility rentals; however, these will be optional and will not limit general public access to the park. November 2022 ITEM 8 - STATEMENT OF ACCESSIBILITY All facilities improved with this grant project must meet current Americans with Disabilities (ADA) standards and the final guidelines for Outdoor Developed Areas. In addition, all critical existing components of the park listed below must be accessible to persons with disabilities. Critical components include: • Accessible parking spaces serving each area of the park. • Restrooms, if provided, must be accessible. • Drinking water, if provided, must be accessible. • Access routes to all recreation facilities must be provided. For this program, an access route must be a minimum of five feet wide, slip resistant, firm and stable. If the restrooms and/or drinking water are not accessible to persons with disabilities or access routes are not provided to all facilities, you will need to include these costs in your Cost Breakdown. Common park elements: For common elements that your park might offer (existing or new), ADA considerations must be included: at least one accessible picnic table, accessible entrance into play areas or sport courts, a walkway leading to the first disc golf tee, etc. View standards below for all other facilities. The following guidelines will help you design your facilities. Copies can be ordered from the U.S. Access Board at (800) 872-2253 or downloaded from their website at United States Access Board. • ADA Accessibility Standards for Buildings and Facilities (For buildings and certain recreation facilities including playgrounds, recreational boating facilities, and fishing piers) • Final Accessibility Guidelines for Outdoor Developed Areas September 26, 2013 (For outdoor developed areas such as campgrounds, picnic areas, trails, and beaches. These guidelines, developed for federal facilities subject to the Architectural Barriers Act, are to be used for facilities improved by this Outdoor Recreation Grant Program.) 1. How does the proposed project address access requirements under the ADA Standards, Final Accessibility Guidelines for Outdoor Developed Areas and all critical components identified above? Be specific for each proposed facility and existing critical components, providing details to the extent possible. The proposed project will comply with all applicable Americans with Disabilities Act (ADA) Standards and the Final Accessibility Guidelines for Outdoor Developed Areas, ensuring accessible use of both new and existing park facilities. Accessible parking spaces will be provided with compliant dimensions, signage, and accessible routes connecting directly to the splash pad, trails, and gathering areas. Primary accessible routes will be a minimum of five feet wide and constructed of firm, stable, and slip-resistant materials, including concrete and Kafka November 2022 stabilized granite mix, with slopes and cross slopes designed to meet ADA requirements. Accessible drinking water and restroom facilities will be provided, including ADA-compliant portable units outside and accessible restrooms inside the barn. In addition, the Water Tower Barn itself will be fully accessible, including lift access to basement-level restrooms and mezzanine-level museum exhibits. The splash pad will be designed as a zero-depth aquatic play feature with flush entry, allowing full access for individuals with mobility limitations and eliminating barriers to participation. An accessible pathway adjacent to the splash pad will lead to shaded picnic areas with accessible tables, supporting comfortable use by individuals and families of all abilities. The trail system and wetland boardwalk will be designed to meet accessibility guidelines for width, surface stability, edge protection, and allowable running slopes, providing inclusive access through varied terrain. Accessible seating will be incorporated throughout the site – including at the amphitheater -- and gathering areas will be designed to support users of all abilities. Together, these elements ensure that accessibility is integrated throughout the site, creating a safe, inclusive, and welcoming environment for all visitors. November 2022 ATTACHMENT A - APPLICANT’S RESOLUTION BE IT RESOLVED that the City of Scandia, Minnesota, act as legal sponsor for the project contained in the Outdoor Recreation Grant application to be submitted on March 31, 2026, and that City Administrator Kyle Morell is hereby authorized to apply to the Department of Natural Resources for funding of this project on behalf of the City of Scandia. BE IT FURTHER RESOLVED that the applicant maintains an adequate Conflict of Interest Policy and, throughout the term of the contract, will monitor and report any actual or potential conflicts of interest to the State, upon discovery. BE IT FURTHER RESOLVED that the City of Scandia has the legal authority to apply for financial assistance, and it has the financial capability to meet the match requirement (if any) and ensure adequate construction, operation, maintenance and replacement of the proposed project for its design life. BE IT FURTHER RESOLVED that the City of Scandia has not incurred any development costs and has not entered into a written purchase agreement to acquire the property described in the Cost Breakdown section on this application. BE IT FURTHER RESOLVED that the City of Scandia has or will acquire fee title or permanent easement over all the land described in the boundary map or recreational site plan included in the application. BE IT FURTHER RESOLVED that, upon approval of its application by the State, the City of Scandia may enter into an agreement with the State for the above-referenced project, and that the City of Scandia certifies that it will comply with all applicable laws and regulations as stated in the grant agreement including dedicating the park property for uses consistent with the funding grant program into perpetuity. NOW, THEREFORE BE IT RESOLVED that THE CITY OF SCANDIA ADMINISTRATOR is hereby authorized to execute such agreements as necessary to implement the project on behalf of the applicant. I CERTIFY THAT the above resolution was adopted by the City Council of the City of Scandia, Minnesota, on March 31, 2026. SIGNED: WITNESSED: ________________________________ _____________________________________ (Signature) (Signature) _______________________________ _____________________________________ (Kyle Morell, City Administrator) (Date) (Steve Kronmiller, Mayor) (Date) November 2022 ATTACHMENT B – MAPS 1. Location Maps: Scandia is in Washington County, Minnesota. The maps below show where Washington County is located in Minnesota; where Scandia is located in Washington County. This is followed by a detailed map showing the cities surrounding Scandia, as well as a close-up of the location of WATER TOWER BARN SCANDIA arts and heritage center is located (the site of the Water Garden Play Area). Washington County Scandia’s location in Washington County, Minnesota Scandia is outlined in red/white on this map. Scandia is located in the St. Croix River Valley, midway between Stillwater and Taylors Falls/St. Croix Falls (located where the map says “National Scenic Riverway”). Forest Lake and I-35 are just west of Scandia. Wisconsin is to the east, with the St. Croix River running between the two. November 2022 ATTACHMENT B – MAPS continued This map zooms in on the Scandia Village Center, which is located just south of Highway 97/Scandia Trail North. The area circled in red shows the ball field park that will be converted to WATER TOWER BARN SCANDIA, just south of Scandia City Hall. The park entrance is on Olinda Trail North. This image zooms in on the site for WATER TOWER BARN Scandia. The entrance to the park is shown on Olinda Trail North. This image demonstrates the site’s proximity to Scandia City Hall/Community Center, Gammelgården Museum, the future Wetland Trail, and the future Gateway Trailhead. November 2022 ATTACHMENT B – MAPS continued 2. Boundary Map: The map must clearly indicate the area to be acquired and/or developed as well as the proposed boundary of the larger park/recreation area that would be subject to the perpetual protection provisions, all known outstanding rights and interests in the area held by others, total acres within the boundary, and a north arrow. The Boundary Map will become part of the grant contract, so it is important to have an accurate map. November 2022 ATTACHMENT B – MAPS continued 3. Recreational Site Plan – WATER TOWER BARN SCANDIA Color Coding for map/plan • Red Park boundary (dashed line) • Green Existing facilities that will remain. • Yellow Development of facilities accomplished with this grant • Blue Work outside project scope – Construction planned for 2026 November 2022 ATTACHMENT C – PROJECT TIMELINE Please include a project timeline for the activity. The timeline should start at month “1” and reference duration in months. Do not provide specific dates/months in the timeline. Please reference the Project Timeline Template for guidance. You may use this template for your timeline or produce something similar. November 2022 ATTACHMENT D – PHOTOS Please include photos of each existing recreational facilities/structures and all buildings. Below each photo, indicate the year the facility/building was constructed and status (remain as is, to be renovated, or to be removed). NOTE: No structures exist on the site at this point. The site is currently an underutilized ball field. Construction is slated for 2026 on site amenities to be built BEFORE the Water Garden Play Area. The project presented in this grant (Water Garden Play Area) is slated for construction in 2027. November 2022 November 2022 November 2022 November 2022 ATTACHMENT E – PLANS Please submit all applicable plan(s) according to the directions provided below. Playground and Splash Pad Plans Priority will be given to playground and splash pad designs that provide a high degree of safety and accessibility. The facility should be designed to provide an integrated play setting for both children and parents/care providers of all abilities. Playground facilities must be, at a minimum, designed using the ADA Accessibility Standards, Chapter 10, 1008 Play Areas. Applications that do not include enough information to determine the degree of accessibility and safety typically do not score high enough to receive funding. The playground plan must legible and include the following: 1. Show all the proposed playground components and all existing components that will remain. Label each component with its name and the height of its useable surfaces. 2. Identify all type(s), depth(s) and location(s) of the fall-protection surfacing. The splash pad plan must be legible and include the following: 1. Show all the proposed water components. Label each component with its name and the heigh of its useable surfaces. November 2022 ATTACHMENT F: Certification not suspended or debarred Instructions: Instructions for agencies are in red. Delete all instructions before issuing. CERTIFICATION: NOT SUSPENDED OR DEBARRED BY THE STATE OF MINNESOTA OR THE FEDERAL GOVERNMENT This form is relevant for all grants. Grant applicant must certify to this condition required under this Grant Request for Proposal INSTRUCTIONS: Sign below to finalize response and submit this document as part of the response to the RFP. ______________________________________________________________________________ Office of Grants Management (OGM) Policy 08-04: Grant Contract Agreements and Grant Award Notifications requires that agencies must not award a grant to a vendor or grantee that has been suspended or debarred from doing business with the State of Minnesota or with the federal government. By signing here, I warrant that my organization has not been suspended or debarred from doing business with the State of Minnesota or with the federal government. I certify that this information is true, correct, and reliable. The submission of inaccurate or misleading information may be grounds for disqualification from the grant contract agreement award and may subject me and my organization to suspension or debarment proceedings, as well as other remedies available to the State, by law. Print Name Signature Title Date November 2022 ATTACHMENT G: Certification of no conviction of felony financial crime Instructions: Instructions for agencies are in red. Delete all instructions before issuing. CONVICTION OF FELONY FINANCIAL CRIME BY A PRINCIPAL This form is relevant for grants of $50,000 or more that are competitive, legislatively named, or single source. Grant applicant must certify to this condition required under this Grant Request for Proposal. INSTRUCTIONS: Sign below to finalize response and submit this document as part of the response to the RFP. Upload or attach an organizational chart or list of principals that you are certifying for below. Minnesota Statutes 16B.981 Subd. 2 (6) requires that no current principals of a grantee have been convicted of a felony financial crime in the last 10 years. A principal is defined as a public official, a board member, or staff (paid or volunteer) with the authority to access funds provided by this grant opportunity or to determine how those funds are used. By signing here, I warrant that no current principal of my organization has been convicted of a felony financial crime in the last 10 years. I certify that this information is true, correct, and reliable. The submission of inaccurate or misleading information may be grounds for disqualification from the grant contract agreement award and may subject me and my organization to suspension or debarment proceedings, as well as other remedies available to the State, by law. Print Name Signature Title Date November 2022