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• .. <br /> New Multiple Dock License Application <br /> SLIP SIZE CATEGORIES <br /> 1 BSU ir) I WSU (each slip up to 20' long and/or up to 10'wide) <br /> ;1, BSU @ 1.5 WSU (each slip up to 20'-24' long and/or up toll' wide) j <br /> f / BSU @ 2 WSU (each slip up to 24-32'long and/or up to 12' wide) ;? l�!' <br /> 2-. 5 BSU @ 2.5 WSU (each slip up to 32-40' long and/or up to14' wide) \a.S .i <br /> BSU @ 3 WSU (each slip up to 40-48'long and/or up to 16'wide 3 3 <br /> BSU @ 4 WSU (each slip over 48' long and/or over 16'wide) <br /> )// 7 BSU and WSU Totals l-i.5-- / �`� // <br /> 14. Fee Calculation: <br /> Basefee>>>>>>>>>>>>>>>>>>>>>>>>>>> $500.00 <br /> iJ <br /> Number of Watercraft Storage Units(WSU) 11 -S x$7.50= $ -t-3} -ate /DSO' (4 <br /> Total Fee Enclosed .........................................................$ Cr-1-1 ..--D-5— 605.06) Gni, <br /> I certify that the information provided herein and the attachments hereto are true and correct; I understand that any <br /> license issues may be revoked by the District for violation of the LMCD Code. I agree to reimburse the District for <br /> any legal,surveying,engineering, inspection,maintenance or other expenses incurred by the District in excess of <br /> the 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 determine whether or not the Code of the District is being complied with. <br /> I agree to submit a cert. ied,as-built survey upon completion of the docks. <br /> 6 79/7 5/ <br /> it •' ed Signature Date <br /> Title <br /> Return this application,attachments and fee to: <br /> Relationship to Owner <br /> Lake Minnetonka Conservation District <br /> 18338 Minnetonka Blvd. <br /> Deephaven,MN 55391-3232 <br /> Fax: (952)745-9085 . <br /> Page 3 of 3 MAY 1 1 2004 <br /> _ J <br /> By <br />