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JUN-28-2004 10�20 FROM TO 9522494616 P.04/04 <br /> �' .. � . � ° �����`� <br /> :r J�`'` � 1, 2004 � <br /> � �� � ~�� <br /> � � ermi <br /> ' SHORELINE EROSION PROTECTION -� FAST TRACK PERMIT <br /> MINNEHAHA CREEK WATERSHED DISTRICT(MCWD) <br /> GRAY FRESHWATER CENTER ' <br /> 2500 SHADYWOOp ROAD Ph: 952�71-0590 <br /> EXCELSIOR, MN 55331 Fax: 952-471-0682 <br /> R• �� h�r <br /> I, �•.��rcl� �t�� _reside at 2 od� S4� o�ol � <br /> (PropeRy Owner� (Street Add s) ' <br /> . . -� wa�,;� � S5S9/ � <br /> ' '����`�'" � ��)�=�[��equest approval to install riprap <br /> ��YI (Statel (ZiP) (Phone) <br /> shoreline erosion protecfion on property described as 2d0o S'�,� uu�w� i� ' <br /> �.._._.^ _,located in <br /> • (Street e dross) � <br /> drd'�� -- . �+^"e Q 1 '� _, � — -.23_;l,po 01 The riprap installation <br /> (Within the City boundaries) (Gourity) (Propariy ID# (PI�#J� <br /> will consist of�s"32 alon �the shoreline of �H K�.� k ,_Cr ys ;�in full <br /> 9 �.�._� <br /> (Lineai feet) (Lake) (Bay) <br /> . accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for <br /> riprap placement�equired for issuanc� of a Fast Track Genera) Permit. ! have conttacted with <br /> �oc,k,� �.i-� l�hc. �55U �.v�orelin� 'Dr, nn �� a.5'L/�7►�3�3 <br /> (Name of Company) � (Street addro�) (Clty) (Lp) �phpne� <br /> 3�g��� ,to perform the work who is familiarwith the technical <br /> (Bond Number) <br /> ' requiremerrts and has futfilled the bonding requirements of the watershed disirict(see page <br /> iwo). I have read and unde�stand the requirements af the MCWD relating to Shoreline Erosion <br /> Protection. . <br /> ����^�- � � � <br /> (Signeture of Propeily Ownar �' 10/I (o�(�3 <br /> (Date) <br /> � Subscribed and swom t before me on ihis ��o �' day of��lA�JI_ ,�`�20� <br /> � • ' " <br /> NOta PubliC . SHERYL A.LATTERNER • <br /> ' WOTARY PUBuO�MINN�OTA <br /> �. MY COMMIS�ION EXPIR6i t.31-8005 <br /> . � <br /> Approved by:_ �/,yM� �' <br /> e �.� .1 Date <br /> DisWbu6on: ,Properiy Owner ^,Conbackor _Munldpality �DNR �D�trict File <br /> Page 1 of 2 <br /> Tf1Tf11 D fAil <br />