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Page 2 <br />Name s%Lt 4;j /✓ dl Gf/V <br />LAKE MINNETONKA CONSERVATION DISTRICT <br />Commercial and others, where applicable, provide the following additional <br />information: <br />7. Check the nature of services and parking provided: <br />a) Boat storage _ No. of parking spaces <br />b) Launching ramps___, _ " <br />c) Sales____ it <br />d) Service it <br />e) Boat rentals _ __— _ of <br />f) Restaurant__ ___^_ of <br />g) Other <br />h) Parking not required______ Total <br />Reason:_ _ <br />8. Sanitary facilities are provided: Yes �NO_ <br />9. Boat toilet pumping service is provided: Yes <br />_ I <br />number of units <br />No <br />I certify that the information provided herein and the attachments hereto are <br />true and correct statements and I understand that any license issued may be <br />revoked by the District for violation of the LMCD Code. I consent to permitting <br />officers and agents of the District to enter the premises at all reasonable <br />times to investigate and to determine whether the Code of the District is being <br />complied with. <br />Date ��/ �7 Authorized Signature <br />Title_ GC� <br />Relationship to ouner__ _ �— <br />