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l..ikc Minnetonka Conr.ervnt 1 t>n Mslrlct <br />LMCD Fee f_ _ _ _ <br />Village response due <br />received <br />I <br />Because this form is I <br />to be copied, please | <br />use black ink or type <br />(for LMCD use) <br />License Year <br />No. of Boats <br />Boat Density Index_ _ _ _ <br />Can be reached at phone # <br />APPLICATION: MULTIPLE DOCK. RAMP. <br />AND/OR MOORING LICENSE <br />PAULA. SCHERBER <br />(Print or type owner's name) <br />3900 Walden Road, Wayzata, Mlrtncsota 55391 <br />476-2A69 <br />(Owner's address) <br />the owner of land In the City of Qrono Peering Islaind <br />Business name: Excelsior Bay Yacht Cliib. Inc. <br />Phone; If no <br />answer, call: <br />(Street address) <br />(if different from owner) <br />685 Excelsior Blvd.. E?ccelsior, Minnesota 55331 <br />N/A <br />Phone, if no <br />ansi/er,,csll: <br />685 Excelsior Blvd., Excelsior. Minnesota 55331 <br />(Hailing address if different from street address) <br />which is riparian to LMCD area(s), Number(s) <br />I.ake Minnetonka, applies pursuant to LMCD Code Chapter III, Section 3.08, for a new or <br />revised Multiple Dock License, in accordance with all data and other information sub** <br />herewith and made a part hereof* The following.must accompany this application <br />(see samples): <br />(a) Locator map <br />(b) County plat of thd area <br />(c) Certified survey and <br />legal description <br />(d) Site plan of dockage to over* <br />lay.survey <br />(e) Dock construction detail sheet <br />(f) Gas storage detail sheet <br />1.Type of application <br />(please check one): <br />( )(K:tlot association <br />( )Multlple dwelling <br />( )Private multiple <br />( )Municipal ( )Connercial marina <br />( ) Trans lent (^Private club <br />( )Other (explain)_ _ _ _ _ _ _ _ _ _ <br />2. Intended use of facility private yacht cl\ib <br />3.Abutting property ownera at the lakeshore: <br />North or West NONE • • <br />• t0 • <br />(Name and HAILING address) <br />South or East NONE <br />(Name and MAILING address) <br />Other affected parties NONE <br />A. <br />(Names and HAILING addresses * attach sheet If necessary) <br />All required permits, licenses and approvals have been obtained from the City in <br />which the multiple dock is located, and the MN DNR: Yes applied far No_ _ _ _ _ _ <br />5. Public liability insurance: Amount $; Company