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•ip cod* <br />D destroy or control: <br />vegetation <br />vegetation ' <br />inner*8 itchT <br />unty. The lake is <br />is must be conpleted.) <br />feet. <br />water. <br />tU.y). Nane of <br />f Yes <br />apply? No Yes <br />il applicator <br />inical is to be usedt <br />licate: the conpass <br />joint, bay, etc., <br />of each property <br />le located for <br />ron: <br />led treatnent area, <br />oposed to be treated, <br />d. <br />jxinuafee is $50.00). <br />accoapany application, <br />t Other <br />ction of water plants <br />f Natural Resources. <br />le or bay^, an <br />ing the shoreline <br />reatnent of a contin- <br />L, all the persons <br />Lgnalures of property <br />lit ted on an <br />U\ <br />1. 1 (U.) <br />4, <br />.1' <br />4 <br />XI. <br />Bone address ^ <br />‘°'5e:*~VoV-oVt-r?U <br />Um B* control ofj autaereed Y.getation ____, eaergent vegeution <br />Liro cl vegetation___. emergent vegetation-----T <br />ra , filanentous algae . leeches . snails (swinner's itch^Line D- Plankton algae <br />XXI. in Lake <br />Iocs tedl.n Township No.Range No.Section(s) <br />County. The lake is <br />XV. The siee of the area to be treated is: (Fill in where applicable) <br />—^_ _along shore by_ _ _ _ _ _ _ feet lakeward out to a depth of <br />channel long and __ _ _ _ feet in width extending to open water. <br />(This must be conpleted. ) <br />feet. <br />The whole lake or bay of <br />bay_ _ _ _ _ _ _ <br />m -- - -— —u ^a • <br />acres in area, (plankton algae only). Nane of <br />1. &ve you ever applied for a permit to treat at this location? No <br />If a^wer is Yes, give your permit number______, and the year Yes <br />2. Is the area to be treated used for drinking water or public water supply? No <br />(Ltm ^^5 ^be 'lork be done by: Applicant_ _, Commercial applicatoriName of commercial applicator) <br />give^brand^nLer^^^*^ «nd/or chemical(s) will be used: (If chemical is to be used, <br />fb«tch the proposed treatment area on the back of this form. Indicate: the conpass * <br />irection North on the sketch, location on lake, which shore, point, bay, etc., <br />dimensions of proposed treatment area, names and total frontages of each oropertv <br />owner. Include enough detail on the sketch so the property can be located for <br />possible inspection. <br />J-V^TIFICATION: (Lxplain why this project is needed.) I <br />VI. PgytlT (Refer to Section II above.) If you checked an item from: <br />Line A» the fee is $5*00. <br />Line the fee is $5.00 plus $0.10 per shoreline foot of the proposed treatment are*. <br />Line C- the fee is $1.^ per 100 shoreline feet or portion thereof proposed to be treated, <br />Line D- the fee is $5.00 plus $0.10 per acre proposed to be treated. <br />If two or more lines are checked, only the largest fee shall apply (maximum fee is $50.00). <br />DO NOT SEND CASH. Make checks pe.yable to STATE TREASURER. F'-e must accompany application <br />PICl/>o tJF.g..j: oketcl ”, , Signatures , Check/raoney order __, Amount _ , OtherVII <br />control of aquatic nuisances, including destructioi of water plants <br />and ali^ae, is subject to rules and regulations of the Commissioner of Natural Resources. <br />DateApplicant's sign'iture*iMIliisiSIfc <br /><»^rB and the dimenaiona of th. aroaa to be treated by each may be autaiUeHn « ' <br />•aaitional sheet of paper*._____________________________________________________ _________ <br />i'1 <br />L’i s <br />•tudy <br />Office <br />■ant o <br />f' <br />XXX. LAKE N <br />townsh <br />us loc <br />raadin <br />office <br />XV. AREA <br />as acc <br />area n <br />M Itei <br />Xtem ^ <br />or pen <br />Item k <br />you Wii <br />vegetal <br />be use< <br />Xtem 6 <br />VX. <br />coming <br />JVSTir <br />IPS: <br />how mu( <br />nuiaanc <br />to *»STI <br />treatme <br />Xxmmpli <br />cuttini <br />plua $1 <br />only (a <br />your mo <br />DO NOT <br />VXX« ENCLOSU <br />items, <br />the STA <br />appropr <br />On rece <br />1. Read <br />Know <br />alloi <br />3. Notil <br />4. Read <br />and c