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10/14/2025 12:58:42 PM
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' 1 Y77 <br />se YeA4._ <br />LAKE MINNETONKA CONSERVATION DISTRICT63 <br />402 East Lake Street No. of boats <br />Wayzata, Minnesota 55391 Boat Density Index <br />473-7033 Can be reached at phone : <br />k 3l-16 l6 <br />APPLICATION FOR NEW OR REVISED MULTIPLE DOCK AND OR MOORING LICENSE <br />ill ej t� y�C C(PQv <br />Print or type owner's name- <br />-7? 0?J 1_ rceblw �Vvltl i�Z ov <br />Owner's address -------------- ----------_----- Phone <br />the owner of land in the City of 0 Lulf a <br />Business name:-51k 4 kJ mAt,l,t,---------- --' — <br />If dif erent om owner <br />(Street address %- K�IliTM <br />rjg address if different from street address - <br />which is riparian to LMCD area(s) - , No(s) , <br />Lake Minnetonka, applies pursuant to Chapter III, Section 3.08, LMCD Code, for a <br />new or revised Multiple Dock License, in accordance with all data, and other in- <br />formation submitted herewith and made a part hereof. The following must accompany <br />the application (see samples attached: <br />(a) Locator map H Site plan <br />(b) Survey (or plat) (a) Dock construction detail sheet <br />Permit or licenses may also be required from the municipality and from the <br />Minnesota Department of Natural Resources (for permanent docks. <br />Data: / <br />1. Type of application (check): Privat. , Commercial-y Multiple <br />Dwelling , Club , Other (explain) <br />2. The maximum number of boats stored in the water at docks is 43 <br />3. The maximum number of boats stored in the water at moorings is O <br />4. The maximum number of motorized or sail boats drystored for Lake use is <br />5. Public liability insurance: Amo•,mt $ 3001DOip Company laelwe -ZkJ (+. <br />6. All required permits, licenses and approvals have been obtained from the City <br />in which the multiple dock is located, and the M.D.N.R. Yes t",/No <br />(Continued) <br />
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