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Permit �I <br /> Sandblanket Permit and Sand Source Exhibit Form <br /> FAST TRACK PERMIT <br /> MINNEHAHA CREEK WATERSHED DISTRICT(MCWD) <br /> 18202 MINNETONKA BLVD. Ph: 952-471-0590 <br /> 051 EPHAVEN, MN $5391 Fax 952,471.0682 <br /> 1, l r&-L reside at VW—Y rmPae�t-i <br /> N 1 bJV 7 _request approval to instep a sandblanket on property described <br /> 9Gi�. <br /> es a located in L-grn a L,..k e Q�►� -- <br /> 3netoddr=) _`sr(KW*r4eciyboundaries) leoumy� <br /> 0�-117 e3. ��l�On A <br /> (PtOPWW P t I ' <br /> 1 haus oointraeted withL.4or@ CgKe YES Add�esl <br /> —�Pam d cam — (Spnota0ora�sl <br /> Y7/- 0;L 17 to install clean sand from the <br /> City.sate, ( eel r� <br /> following Source a't co m OCroYsi i +y. D <br /> SPIN <br /> enol • <br /> I wil install the sandblenkst from 1he following source Al Am ere CAnt _ WA CAL'-'& G <br /> MPPW <br /> Pami .� •• �aa.� IPnone <br /> . O <br /> My shoreline is _feet and the dimensions of the proposed sandblanket are: 02 X <br /> i'� <br /> X 3andblanket dimensions cannot exceed a length of 50'(or 50% of shoreline). <br /> — pair <br /> aiAwidth'i of 10' and a depth of W. it this project requires municipal approval or review, please attach <br /> documentation of the municipal approval with this application. <br /> I understand that if this application is not completely Med out, or if I fail to submit the required exhibits, the <br /> application is incomplete and wiN be rctumed. It will not be reviewed by MCWD staff unfd complete. By <br /> signing this application, I agree and understand that the District may enter the property at reasonable hours <br /> to conduct an inspection to determine whether the terms of the permit are being met. I fyrther understand that <br /> N 1 violate the terms and conditions of the permit that is issued based upon this application, the Di.trict shall <br /> conduct a field inspection of the project per MCWD Rule J. provided with this application. I understand the <br /> pistriet will charge tees to cover the actual casts of field inspections, Including investigation of the area <br /> affected by the wont, analysis of the work, including the services of legal counsel and engineers, and any <br /> subsequent mohitoring of the work.The District's actual eosts are deemed to begin accruing when the District <br /> issues notico of the violation to permittee. I (lave read and understand the MCWD Technical Guidelines For <br /> sen b nkets. 'j oP a .Tsr�•.( <br /> _ 7,Wer Qr.•re*r 0 L,.n e- 0 s <br /> Oa ' <br /> Subscribed wand sworn to before me on this f. day of—;T-4e <br /> VIA! <br /> No ` <br /> •si�.:7�1;i Ir�ElO•�t:k..ie7C�'� , <br /> Sir 0:3NNA ua Ewa or,.61.M1 <br /> r <br /> ApprovedIV by: �vData <br /> SUN 14 2005 <br /> TOTAL P.01 <br /> TOTAL P.92 <br /> Z00/Z00'd ML# zxv'I oxoq 30 xZIo ZZ96 90 Z96 TZ:80 900Z,L0•7nr <br />