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lYew Multiple Dock License Appiication <br /> 12. WatercraR Storage Unit(WSU)computation schedule: <br /> SLIP SIZE CATEGORIES <br /> � BSU @ 1 WSU (each slip up to 20' long and/or up to 10' wide) 1.00 <br /> 5 BSU @ 1.5 WSU(each slip up to 20'-24' long and/or up to 11' wide) 7.50 <br /> 69 BSU @ 2 WSU(each slip up to 24-32' long and/or up to 12' wide) 138.00 <br /> 18 BSU @ 2.5 WSU(each slip up to 32-40' long and/or up tol4' wide) 45.00 <br /> 19 BSU @ 3 WSU(each slip up to 40-48' long and/or up to 16' wide 57.00 <br /> 2 BSU @ 4 WSU(each slip over 48' long and/or over 16' wide) 8.00 <br /> 114 BSU and WSU Totals 256.50 <br /> 13. Fee Calculation: <br /> Base fee»»»»»»»»»»»»»> 500.00 <br /> Number of Watercraft Storage Units(WSU) 256.50 x$7.50= $1,923.75 <br /> Total Fee Enclosed .........................................................$2,423.75 <br /> I certify that the information provided herein and the attachments hereto are true and correct; I understand that any <br /> license issued may be revoked by the District for violation of LMCD Code. I agree to reimburse t6e District for any <br /> legal, surveying, engineering, inspection, maintenance or other expenses incurred by the District in excess of the <br /> amount of the application fee. I consent to permitting officers and agents of the District to enter the premises at all <br /> reasonable times to investigate and to deterrrtine whether or not the Code of the District is being complied with. <br /> I agree to submit a certified, as-built survey upon completion of the docks. <br /> f 2- !S-l3 <br /> Aut6orized Signature Date <br /> /�la�asre/ <br /> �Title <br /> _�0✓1 Return this application,attachments and fee to: <br /> RelaHon�6ip to Owoer <br /> Lake Minnetonka Conservation District <br /> 23505 Smithtown Road,Suite 120 <br /> Shorewood, MN 55331 <br /> Fax: (952) 745-9085 <br /> D <br /> FEB 15 2013 <br /> Page 3 of 3 <br /> �y <br />