MCWD Permit 19-388 Riprap - Laserfiche WebLink

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LAKE SHORELINE STABALIZATION PERMIT APPLICATION FORM MINNEHAHA CREEK WATERSHED DISTRICT (MCWD) 15320 MINNETONKA BLVD. Ph: 952-471-0590 MINNETONKA, MN 55345 Fax: 952-471-0682 1. Property owner information: Name of each property owner: \-1-1. > Mailing Address:ae ( ' nt,t1 City: CYLON1.0 State: MN Zips 5.5 Email Address re Fn2r,(°t}rn Phone: I5%,f Q -7c3 :7 2. Contractingcompanyinformation: Business Name: t T¢X,...1`c4 L\ 1 Representative Nam N\ -j j N- BusinessAddress:L O2i..0JE i`L2((.��VE. CityNT-1P Pre1L, State: MN Zip: 53 4 Email Address: lc O do( �l�t'T CCS Phone: Ongoing performance bond with MCWD: @-Yes ❑ No Bond Number: � 9 13 3. Project Details: Project address:9�L 5 N(j ,.LTI}jr 1 1`�t City: O �0 State: H N Zip:551/1 County: S , -r\t 1�L i V`4 Property ID number (PID): Type of Project: ❑Vegetative restoration ❑ Bioengineering iRiprap ❑Retaining wall In-kind replacement: ►'f_)egYes El No Erosion intensity score (if not in-kind replacement): Located on lake: H INA H t��TC F-A Length of shoreline affected: 50 (lineal feet) Describe any existing structure along shoreline: 5COAt'fe.S. Bc;,�tr�rt� Vri.jtiv3 n tc3 1.44_14.e Access to project site by: ❑Icerge ❑Upland corridor Financial assurance bond acquired: ❑Yes ❑No (If not an ongoing performance bond please fill out next page) By signing below,I hereby request a permit to authorize the activities described herein. I certify that I am familiar with MCWD Rules and that the proposed activity will be conducted in compliance with these Rules. I am familiar with the information contained in the application and,to the best of my knowledge and belief,all information is true,complete and accurate. I understand that proceeding with work before all required authorizations are obtained may be subject to federal,state and/or local administrative,civil and/or criminal penalties. -1/Cif Slgnagar2154e1 erty ownerontracting representative Dat Page 1 of 2