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<br /> �7- ��
<br /> MINNEHt�HA CR��� '�'�VATERS��D DISTR.ICT
<br /> Gra� Freshwatiex Fa�undat�on - Suite 37 Ph: 471-0590
<br /> 25d0 Shadywood Road, Excelsior, MN 55331 Fax: 471-Ob$Z
<br /> SHO���II'�E ERtJSYON PR(]'�'�CTIQN- FA,ST TRACK �ERMYT
<br /> I, e� � residing at 13*1�- f�aa�T �d►.,,.�` ��3� .
<br /> ('PropCftY Owncr} (Street Adiii'css) - -
<br /> �a w„� , �N►� _ b . P�-T: ��� -1�.s� , request appror�al tc� install
<br /> (City) � (Stuta.Zip)
<br /> riprap shoreline erasion protection on prvper�y descrihed as ��,�.,� , located in
<br /> cstrzet Aaarzss)
<br /> -- ----- -
<br /> �_R.ort.o .. ,
<br /> _ C71 - i I R7 �'� �oo � . The rip rap instailation
<br /> ----.. - .,_,_.._.._,.. - ._,.._�..�
<br /> (Cily) (Counhy) (PIDfI locatecl an lax slpteit7e�lt)
<br /> will cansist of '�n along the shoreline�f ��-�� ,�� ��� , in �ta.11 accordance with
<br /> {Linuil fe�t) (Lalce} (��y)
<br /> the Minnehaha Cree�:Waterslled District Shareline Protection Guideline for riprap placement rec�uired far
<br /> issu�ce of a Fast Track General Fermit_ I have contracted with
<br /> _ '�NCFDT LAND�CAOING , ,,._
<br /> (Nxme ot'(,'�b'�r�RlE$T LANE (n�lclress) � (i't1on4)
<br /> MQUND, MN 55364
<br /> ____ , to perfonn the work who is familiar witl� the technical requirements and has
<br /> (8ond Nwnbe:r)
<br /> fiitfilled the bonding requirements of the w�terslied district {see reverse) . 1 I�ave rea.d and understand the
<br /> ret�usremen of the r lating to Sl�nreline Erasion Protection.
<br /> {Si��aturc o roperty o�neer) �p,i�v�
<br /> , � . .. _��
<br /> Subscri�ed and sworn to ��etorc me on this � ' da of o o�r�,L-�, 1997.
<br /> y. � ..,,.Y..._ a�-�-,��—.�.,,, ��J J �g �i �c.,-�
<br /> 'S {�.ti . � ��r�r � . .
<br /> �� •`� � � [� � i�w"i�
<br /> ?R��✓�'�-+✓`� � F:! � _�,�
<br /> :�'7L3� �;'` '�`i ° ' ' ,i i ���..'d`Y'
<br /> -- �..i - � _
<br /> �: r�..- a 3 9 99^i{0
<br /> Notary biic �-��,.,�.,...ti,.,K.,,,,�,�,,,..�,,...,s
<br /> ApprOved B_y: t;v.�a,�, ���^� � l f-�j' �7"�
<br /> J es Ha�ner, �7istrict Tec}lni�ian �ta,1iC)
<br /> I)itilrihutioti: Proper�y Owncr Contraclur Mani4ipslily� I]1VR 1)iytn�t ['iEtlf�ngincers
<br /> fast '
<br /> TOTHL F'.�=t1
<br />
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