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■ -■' ■ ■ ,^‘^x ■•■_= ' •■SiJ»: <br />.7.' •■ '■I/- * <br />4 » » <br />itt <br />rS'' <br />■ i.-t'^ <br />fr:« . 'J:,;:WJ - Mfe7V':i? <br />.i -im-^\-iP'. - <br />« <br />7!;; <br />* »'• '..p. ..IK-S, <br />K& <br />fy -iUy. <br />;,v^ <br />vl-'' •,<>. <br />Vv <br />10 <br />'} > 7h|v..' <br />^i|'« ;':fl0. .:■ <br />r^f-c ■■ . <br />m-r- vvr <br />PSl - <br />1;-' > <br />tK <br />'5«s: -4i: <br />S ' :■'<.?' <br />7V.; <br />ffiii <br />m. <br />. -'v:- <br />Lake Minnetonka Conservation District <br />Open Water Fishing Contest <br />Special Event License Application _ _ <br />Page 3 <br />In Bass Tournament <br />(Event ) <br />17. <br />18. <br />19. <br />20. <br />All watercraft must have current Minnesota registrations, or appropriate <br />out-of-state licenses as required. <br />Hennepin County Sheriff's Water Patrol requires your application. A copy is <br />enclosed. jo( <br />Other agencies m^y also require your applications and their approvals, such as <br />MN DNR (772-7950), city/cities, and Hennepin Fark.® (Guest Services, 559-6720). <br />FEES. Please note; this fee is for processing of the application and does not <br />entitle the applicant to a licen*- or refund. <br />/ ; <br />BASE FEE, includes events up to 4 days. . . . . . . . . . . . . . . . . . . . . $ \1 0 Oy <br />_ _ _ _ days over 4 (? SlO/day. . . . . . . . . . . . . . . . . . . . . <br />Sub Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ^- - - - - - <br />LATE PENALTY, applies to NEW events submitted less than 60 days <br />prior to the event, and applies to RENEWALS submitted less <br />than 90 days prior to the event. . . . . . . . . . . . . . . . . . . . . . . . . ^ ® ® <br />PLUS <br />LICENSE DEPOSIT, refundable, depending upon full compliance with the <br />LMCD Code and extent of administrative, inspection and legal ,\ <br />j -j ......’(*(100.'service required. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —^ <br />TOTAL FEE ATTACHED. . . . . . . . . . . . . . . ^ 2QQ . <br />I certify that the information provided herein and the atcacl.ments hereco are true <br />and correct. t understand that any license granted may be revoked by the District <br />for violation of the LMCD Code. I agree to reimburse the District for any <br />advertising-sign removal, legal, inspection, maintenance or other expenses Incurred <br />by the District in excess of the amount of deposit. I consent to permitting o icers <br />and agents of the District at all reasonable times to investigate and to determine <br />whether or not the Code of the District is being complied with. <br />Authorized signature <br />Date 3/23/92 Title MN Director. In-Bass Tournamen <br />Please return this application <br />and attachments to: —L-.-.Xake Minnetonka Conservation District <br />900 E. Wayzata Blvd., Suite IbO - <br />Wavzata, Minnesota 5539( <br />I 4 1 ' LT ■ <br />liT"'Phone: (612) ^73'/OJ3 <br />' 12/91