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n <br />FfT. 12/Sl I Kinr.rirta Ccr.tervat!on Dapertirent <br />DlVI SION OF KATCNS <br />APPLICATION FOR PERMIT FOR WORK IN THE BEDS OF PUBLIC V/ATERS <br />Under ,V. S. A., Chat'-i-r iCo rind ar t-lic&ble statutes. <br />••••> -tti, <br />V -.1 Ij > <br />RECFl'^r^To: CO. L'lSSIONrB OF CONSENT I ON, *'''•» r ^ <br />Centennial Office Building, AUG ? -0*0 <br />St. Paul 1, Kjj’ncsota <br />Division Of IVA}£RS <br />Tr.e applicant herein is the cv;ner of land described as. <br />r/Ot _^ __ <br />*Gcv€:L;w«roi loi or stci <br />Section _, Town ship.____, Ber.ae <br />Piirclor J»:»f.crti • <br />Or put Jf ^ ^ ____Jr.fc a »d m*. <br />♦ - ^ <br />—?rcirt4i^y <br />Prrrr.ll • <br />—*J*^:ufice W,• <br />1 • <br />!.-^i^ctLn <br />1ifH <br />'s* —' <br />fJU JS’- <br />-rj3 <br />County, <br />which is riparian to .-r A A t \ J^ <br />end applies herewith for a jernii^to wcrk in the bed(s) of the public waters ner.ed above, <br />all in accordance with the data which follc.vs and the rr.aps and plans attached hereto end <br />iTide a part hereof. <br />IT IS PnCPOSr.D TO: [>3^^cevete, C jFill, f_J Construct, f.J Change, I iBenove, <br />r 1 Abandon, (_J Other (specify)___________________. __________________ <br />THE FOLLOWING: I 1 Dike, Q£]Channel, I I Breakv.ater. Ksvetraent, f I Harbor. <br />I 1 Custruction, □Dam, CJEridge, LlDCulvert, [U LH] IVharf, <br />I 1 Boat House, C^Kangar, Other (specify' ______________________ <br />FOR THE PURPOSE OF: I~ 1 Beach improvtrient, UNavigation iroprovement, CID Shore •. <br />protection, I 1Safet.v rr.easure, Lake irprovement, Crossing <br />I 1 Private crossing, (23Flood control, (^Erosion control, | 1 Power <br />development, Q] Other (specify)______________________________________________ <br />CHANNELS <br />Eyi»t inq <br />CONSTRUCT I OK DATA <br />Proposed <br />Length (feet) <br />Bottom wiuth (feet) - - -. <br />Side slopes (ratio) - - _ <br />Average depth (feet)- - - _ <br />SHORE IMPROVEMENT <br />Proposed <br />Distance lakeward (feet) - - - - - <br />Distance along shore (feet)- - - - <br />J.'exirmi»n depth of excavation (feet) <br />Gradient 1%) ----- -________ <br />Depth of excavation (feet) - - - - ____ <br />Material to Liuck & silt------- <br />be removed <br />(cubic yards) Gravel & sand - - _ _ <br />Rock & stone- - - <br />Maximu-r depth of watei (feet)- - - <br />Payment is enclosed in an arciint of v —"___• <br />PLEASE READ BEFOJJE FILLIKG OUT APPLICATION <br />Det*ilod pUns ISo€ Form V7J-5D nusi tccomptLf all e jipl icai i ods lbo5e for i.ork listed beloi^ <br />for which a locatioa plat or sketch, only, is reccired. <br />1. F»acb saodiaf - sii inch naii.Tun: tlieVeess. <br />*. ippro.cb ebaoneU, not )6 f»ei it width, to tont bouses, bsrbors snd piers. <br />3* A1 • rso <br />4. Shore protectios works sot reqniris( filliii| o. Isbe or stresm beds. <br />~ 7-----------------------------------------------------J