Laserfiche WebLink
’^\NNer PERMANENT NON-MULTIPLE DOCK LICENSE APPLICATION <br />Lake Minnetonka Conservation District <br />18338 Minnetonka Blvd. <br />Deephaven, MN 55391 <br />Phone (952) 745-0789 <br />c <br />LMCD Receipt H <br />In accordance with Scc.2.06 of the LMCD Code, llic following application for a pcmiancni dock license shall he <br />completed in all respects and submitted to the District office. No person may locate, construct, install or maintain a <br />new permanent dock on the lake without first securing a license providing that no such license shall be required of <br />docks requiring a license under sec 2.03 of the LMCD Code. A new license is required whenever the size, type, <br />location, or configuration of the dock is changed. No new license Is required for repair or replacement of a previously <br />permitted dock where such repair or replacement docs not alter the size, type, location, or configuration of the dock. <br />Because this form is to be copied, please use Mack ink or type. <br />The person completing this form is the authorized agent or property owner (circle one). <br />Applicant: LiFT, IMCL CTiM ________________ <br />Address: ________________________________ <br />City. State. Zip:9,PC^AJ^'"pAf..C M lU ____________ <br />Phone: /t\V 8.5H3____________Fax: H~11- 7-/<?/ ;? <br />Property Owner (if different fix)m applicant): <br />Address '2-"lh?P <br />Cily,State,Zip: I____________________ <br />Phone: ^t)^ ' ___________Fax: '^izj'^ / 1 <br />Documents listed below are required; and must accompany this application: <br />tSLocator Map DScalcd drawing of docks on abutting properties <br />□County Plat Map DProposed facility site plan <br />|K)Ccrtified l^nd Survey, Legal Description OExisting facility site plan <br />Absence of significant requested data, couid result in a processing delay. <br />I. Type of facility OQ private <br />() a)mmcrcial <br />2. Intended use of dock facility <br />() multiple dwelling <br />() other (explain) <br />3. Abutting property owners at the lakeshore: <br />North or West OtLcMo / <br />mime and addrcsi <br />South or East _ LOiTTHeg. D OH <br />mine and address <br />Other alTcctcd parties________ ____ <br />name and addreu <br />t of 2 <br />iWofi <br />FEB 1 0 2005