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JAN-22-2004 10:47 MINNEHAHA CREEK WATERSHED 6124710682 P.02/02 <br /> Permit # D`i - 016 <br /> SHORELINE EROSION PROTECTION — FAST TRACK PERMIT , <br /> MINNEHAHA CREEK WATERSHED DISTRICT (MCWD) <br /> 18202 MINNETONKA BLVD. Ph: 952-471-0590 <br /> DEEPHAVEN, MN 55391 ( Fax: 952-471-0682 <br /> It-.ifterlP5 S7 $ /' reside at /270 ui1(iiicsrd ''j-ai ( <br /> (Property Owner) (Street Address)) <br /> 0 YOItJO , MA) 6 5-z7(g X12- J/rfequest approval to Install riprap <br /> (City) (State) (Zip) (Phone) <br /> shoreline erosion protection on property described as i, /0 /CJ/1 Clrs-111a{/ocated in <br /> ( eet addre <br /> 017-4/J6 46 p in 07- 111_Z.I�-3(_StrQO/j ss)me riprap installation <br /> (Within the City boundaries) (County) nn(Property ID# IPID#J) <br /> will consist of 1 I'i along the shoreline of / / IIH ka_,'f('s7L / G 01 in full <br /> (Lineal feet) (Lake) Way) <br /> accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for <br /> riprap placement required for issuance of a Fast Track Genera0 Permit. I have contracted with <br /> 1)ei It.c5 x Strut-et' vSg 4.5,5 IA�'GII Mevad 5S3W (!aQ /hp. - (1°7Q>/ <br /> (Name of Company) (Street address) (City) (Zip) (Phone) <br /> , to perform the work who is familiar with the technical <br /> (Bond Number) <br /> requirements and has fulfilled the bonding requirements of the watershed district(see page <br /> two). I ha ead and understand the requirements of the MCWI) relating to Shoreline Erosion <br /> if <br /> - 1 tction. ._______— <br /> IF (Signature of Property Owner) (Date) . <br /> u'• I, =d : i ,wor . t•-'eforemeonthis 17 day of <br /> -71 NJ- , 20�?'�: <br /> I,$ iretk <br /> 1• : STEVEN J HILI <br /> Notary Public '1.:;:q!. <br /> , Noiary rueou-Minneaoia <br /> �� 7;�r <br /> 1.........-- <br /> V AAy Comm Donn Jon 51,2005 <br /> Approved by: �."-.--c - Q Date—414Y— <br /> .---________. <br /> Distribution; _Property Owner _Contractor _Municipality DNH _District File <br /> Page 1 of 2 <br />