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•i:v 15 '93 .14::-52 HOODHILL C.C. P.2/4 <br /> MINNEHAHA CREEK WATE HED,D1STRICT r_____ _FOR OFFICE USE. ONLY <br /> ..,a`� "�„ C7 146500 Minnetonka Boulevard a scan No. <br /> F- 1Permit App''cAt <br /> K w F� Minnetbtlka, MN SSS-15 7 ;--DAte Received _ <br /> +__. Mara `ant - _.. <br /> rends Date y--- <br /> 9$HED'0° APPLICATION FOR PERMIT - FORM A <br /> SEE REVERSE SIER5E SIDIt F11fa TRu TION - -. <br /> t. OWNER: f 2. OWNER'S <br /> c aa , l I REPRESENTATIVE: fes' rRe cOe re;F� �, _ <br /> As <br /> 0..:,,„..) 14nN <br /> (re�oa ) iz a) <br /> T 0 OTHER <br /> C7wnet's SiOnature: << t�p.G R.L.S. �.', <br /> ter = <br /> 3. Project Location: _ <br /> City ;{ (A rel nty FCou .v rJ 114 Se.C_ .1 _ Sec. Township /_ Range -- <br /> 0 <br /> 1 4. Project Ad -� �,.� — <br /> Address: �� � , <br /> 5. Permit Requested For: (Check all appropriate boxes) <br /> B. 0 Stormwater Management Plan C. 0 Floodplain Alteration <br /> 0 Commercial D. 0 Wetland Alteration <br /> Q Industrial E. 0 Dredging <br /> CJ Institutional or Highway F. ar Shoreline/Bank Improvement <br /> D Flesidentiaf <br /> G. 0 Stream/Bank improvement Ij <br /> N TE_- Applicants La in ca Sandblankets Must Use Application For Permit -Form B <br /> 5. <br /> the Project; 0..e <br /> DEscribe (f�) J ,jn y^ /(f^'�} . :—----—— <br /> a0 _•r}U� c , „...5 ,.. i _________________ <br /> t_____.(r...1..sz_______12.4.4iLe. r4_4_ . .:L-/ ,s/ri p4= C— 5', 0 00 _ . e. i <br /> _(If this project requires municipal approval or review, attach documentation of municipal review.) <br /> _: <br /> 7. Body of water, stream or wetland affected by runoff from this site: �- I -7C ' 0...<< -.. <br /> Distance from project: _,,, XSf . •ti4 e' � <br /> 5, Schedule for construction, implementation of temporary erosion control, substantial completion and resto/rration: I <br /> 1 ,...1. ee„xi,n-A.,_ I <br /> 4111 f <br /> /4",,i.,5., is fZ"r7i)-(t- - .0(4L.1. ; I ?r 1 Y _. <br /> _ _ _ <br /> Dia. e, ,..ti / 1 \�o4C_R”n if assistance in comoletino this form is required. in submitting this toren, the y 'applirr)t <br />