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i�CT-11-1�99 10��1 MINhJEHAHA CREEk; WATERSHED 512a?1��682 F.��.�'�i�
<br /> ' � 99 � Zz�
<br /> MINI�TEHAk�A CR�EI�V�'A'I`E�S�ED �ISTI�CT
<br /> �rray Freshwater Foundation Ph: 471-0594
<br /> 25Q0 Shadywood Raad, Exce�SKor, Ml'V 55331 Fax: 471-oG82
<br /> SH�RE�.�,�E Elr�aSIUN PItU'�'�C'�'�ON- �'AST T�tAC� �'ER�YT
<br /> I, ,�i r+,.o�� e��"��w� residisg at �'`� � 9 J�S a r c�►��e �r
<br /> �'t9.
<br /> �pro���� (Slt�et Addrr.ss)
<br /> c� a a. � N �^�� �� . PH: .,�Zlv- d 5'�� . request appraval to instatl
<br /> ��1�� __—• (Stute,2ip)
<br /> riprap shoretine erosion protect'son on property described as � y� � �'�°���•h`� �r located in
<br /> _� , (Str�l Ad�rCss)
<br /> ,�j,v►- ����'.�",Pi�t/ „_,��/t 7• �„�, � 3 D�d 9- The rip r�p instaliation
<br /> (Ciry) EG�►�Y) {�IDi1la;aled on tax statertettt}
<br /> will consist of 9��"��� along tha shocsiine of' Iti'���i�"a"1�"rdC� , �^o w�►,c-.s' , in full �ccordance with
<br /> (�.i�ues!fett) (L�ake? tQ�Y)
<br /> the Iv�nnehaha Creek Watershed�3istrict Shoreline Frot�Ction Guideline for riprap placement r�quired foc
<br /> issuance of x Fast Track Generat permit. I have contracted with
<br /> MINNETOM1f,:.4 I�PRTABLE
<br /> OREOG!r�,��MPANY , _ � �
<br /> (Nannc of Camp w 4, ...;��T (EWdress} (Pf,one)F
<br /> BXCELB►CA,r�*J �s337
<br /> "��`� ____, to perform the wortc who is familiar with th� techRical requirements and has
<br /> (BOt1ti Nust�t►cr)
<br /> tulfilled the bonding�equirements of the watershed distxict(see rev��se) . [ �ave read and understand the
<br /> req ' ments of the M�CWD reiatin to Shoreline�r�sian Protection.
<br /> b,,, ` /`" �- " � � ! MINNEI- ,. .,..� -�.
<br /> a rv .. . lA�,l—i. . ... -':`. ,
<br /> � �� ���•�:�t�::.:.. {Daie} T.;....> ;., . :::�
<br /> . WAYEF�S�1-�.
<br /> Subscribec! and sworn to bef�re mie on this �_d�.y pf , 1999 � � • �•
<br /> �
<br /> . �»An.��.y���MsaAr..�r•.�r.�yn. �,.:.,, ,
<br /> ���i� .. �1 RYgIpUDL1C•MCN ESOF� �� �.�• ' ., �• �,,,,�
<br /> � � a 1',.. ;
<br /> � �,��;� HENNE?iN COl1NTY �
<br /> 5 .
<br /> ary Public � ........ My Cemrn. Fscpires Jan. 31, 2QOQ
<br /> �rti.�y.r/y.ry..r..�qy•.L��A1 �S ��
<br /> Appraved By: �
<br /> . a es Ha er, �listrict Technician (t�at��
<br /> Disl,ribution: Proptriy Owner Coxftractor Mu�iicipulil,y DN7t 1?i��r'tct f il�:
<br /> �
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