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,n � � � �� `��irr r � <br /> Permit*�� ��-� � ;,,�, <br /> 8andblankat Ph�rmi!and S�nd Soures Exhlbit Forrrr <br /> FAST TRACK PERMIT `;;,, ' <br /> --- ------- <br /> -- <br /> _ _ er�� <br /> MINNEHAHA CREEK WATERBHEQ D18TRICT�MCWD) `Z��� � <br /> 1tZOZ MINNETONKA 9LVD. Ph: l6Z-4�1-06�0 � <br /> D�EPMAVEN� MN i8s91 F�x:8a�-471-Q8�Z <br /> Q�� t�Ca�F�. 1` � /� <br /> (, `1 t10.�U ca�a,,r f�alde st .1'�°►� 1�)o�_�o y.���� ��L�r�n t <br /> ( �P�M ��) p►�Mw) <br /> l bI <br /> t ( ' ,'j i ' s t ?�' z��� r�squest approval to instatl a sandblAnket on property described <br /> ae �u.W.�. ,IocoMd in „L��r.� �,_ /.�....r. <br /> l�h�t�dd�wy MA�+►n th�cny dound�de�� �C«,ny� <br /> o� 1il d3 yy Ooa on �4 v� , '(� siaR <br /> —� v�b �-- ) __"�c� <br /> I h�ve ooMracted with CONCEPT LANUS�KPING <br /> , <br /> (scr«t�ddrNe) <br /> MOUND,MN��t to instali ciean sand from the <br /> G <br /> ( H�8at��21P) ! M) <br /> fOKCM1If1Q SOUI'�'`In�� �ctiv�.c�- , � <br /> � <br /> ro�PP�Fen ) ( +��Y, a�"_.._. <br /> 35� 8 � _ <br /> one <br /> I insfsll th dblanket fro fhs foifowinp source , <br /> / ( �N) <br /> �� � � �y s , ( _ � ho <br /> My ohoroNns ie�fest and ths dimen�ione of ths propoesd eandblenket are: �o � X <br /> �. ��� <br /> ,�,_X �o , . S�ndbl�nket dlmensiona oannot excsed a lenpth of 50'(or 5096 oi shoroline), <br /> -,�� <br /> a widfh of 1d' snd a depth of 8". If this projeot roquiros municipal approval or revlew, pleaoe attach <br /> dooumentetion ot the municlp�l opprovAl with this appllcatlon. <br /> I undersGnd thet if thie appl�ation ia not completely Alled out, or If I f�il to eubm(t the roquired exhlbits, the <br /> appllcetlon b Inoomplete and wili be rrtumed. it will not be rovfewed by MCWD ataf'f until complete. By <br /> sipnlnp thia applloation, 1 apree and underatand that the Dletrlct mAy entor the property at roasonable houre <br /> to oonduct an inepsotlon to determine whether the term�of ths permk nre beinp met. I wrMer underotand lhat <br /> H I vlolntte the terma and oondkions of the permit thet ie leeued bsaed upon this applfceNon, the Dletrict ehall <br /> conduot a flsld Inapecllon ot the p►�eat psr MCWD ftuk J, provided wllh thlg applicstlon, I undentand the <br /> DI�Mct wlll cha�ge heo to oover the �ctual coot� oI Aeld inapectione, f�ciudfnp investipetion of the ereA <br /> �fNscted by the wrnk, ansly�is of the work, inoludiny the eeroioea of lepel �ouneel and en�ineera, and any <br /> wb�squent monitorin8 of the work.Tha Oiatrbl'e aotuai ooste are deemed to beyln acc►uin�when the Dist�lat <br /> hwed notk� of the violatbn to permlttee. I have rsad A�d urtderetartd the MCWD Technical Gufdelines for <br /> Nndblenksts. �'�ct�}' - ct,L��Q/y�L <br /> 8uheaibed a�d swo�►n� eforo me on this day of ? ,20 <br /> Notery Puhib <br /> w�,ro�►ed by: o.a � <br />