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' � FOR LMCD USE: <br /> Lake Minnetonka Conservation District Approved by <br /> Date <br /> Fee 4� Inspection date <br /> • Comment <br /> PERMANENT DOCK PERMIT APPLICATION <br /> In accordance with Section 3.032 of the LMCD Code, the following application for <br /> a Permanent Dock Permit shall be completed in all respects and submitted to the <br /> District Office, 402 East Lake Street, Wayzata, Minnesota 55391. No person may <br /> locate, construct, install or maintain a new permanent dock on the Lake without <br /> first securing a permit therefor from the Executive Director pursuant to said <br /> Section, provided that no such permit shall be required of docks requiring a <br /> license under Section 3.08 of said LMCD Code. <br /> A new permit is required whenever the size, type, location, or configuration of <br /> the dock is changed. No new permit is required for repair or replacement of a <br /> previously permitted dock where such repair or replacement does not alter the <br /> size, type, location, or configuration of the dock. Permanent dock permits shall <br /> not be granted where deicing equipment is needed. <br /> Tom anQQr <br /> (Print or type owner's me) ' <br /> 2��� �ha d��,00 d Road Ex�els�'ov MA/ 5.�.�3/ �-9 S8Y <br /> (Owner's address) (Phone) <br /> the owner of land in the City of Dlron o <br /> mailing address or location of permanent dock for which permit is sought: <br /> Z?�5' ShadNwoncr �rc�/s,�/ /rlit/ 53�3/ <br /> Business name, or name of occupant on premises where dock is to be located: <br /> $Q./)7P. <br /> (Phone) <br /> (Mailing addrese if different from street address) <br /> which is riparian to LMCD area(s) Qf�m�ll.� ��.1 , No(s) . <br /> Lake Minnetonka, applies pursuant to LMCD Code Chapter III, Sec. 3.032 for a Per- <br /> manent Dock Permit, in accordance with all data and other information submitted <br /> herewith and made a part hereof. The following must accompany this application <br /> with name, address and date on all submittals: • <br /> (a) Locator map (d) Site plan of dockage on/or to <br /> (b) County plat of the area overlay the survey <br /> (c) Certified survey and legal description (e) Dock construction detail sheet <br /> 1. Type of facility: (�Private ( ) Multiple dwelling <br /> ( ) Commercial ( ) Other (explain) <br /> baia!' <br /> 2. Intended use of dock facility /Y100Y%ZQ <br /> 7/82 . <br />