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V. I 11 roar APPLICATION <br />DEPARTMENT OF T'1 WOK M PIMCTEI ■AT'EM N KTUNK <br />Mlf!!rts (DU A IIRCus■e M■ MFETTI <br />NATURAL RESOURCat <br />►►PNase rod ktstruetiorti before attempting to complete this application. <br />Tire /1Ii:10 <br />Applicant's Nana (Last, First, M.I.) <br />Authorized Agent (iI applicable) <br />T09phornme Numberaorea <br />Don c 3ke James <br />1(612)472-7505 <br />Address (Street. RFD, Box WoW, thy, <br />State, Zip Code) <br />PO Box 58 Navarre :tn. <br />55.392 <br />Government Lo";arter <br />Section(s) <br />Township(s) <br />Raros) <br />Lot, lock, b ivislon <br />ISK*ns(s) <br />18 <br />I 117 <br />2- <br />0003— Lot 2 <br />Box No. or Prtajeet Address <br />County <br />Project will affect Lake, Wetland or Watercourse <br />!iNol <br />n Pt. Rd. <br />Wayzata <br />Hennepin <br />�0 Darn - '.Vest Arm 17 <br />1. PROPOSM MIOiJECT <br />111. PROJECT AREA <br />❑ fill ❑ r•xcayste <br />❑ dam <br />❑ culvert ❑ shore -protection <br />❑ drain M construct <br />O lake <br />O wetland ❑ ether (specify) <br />❑ rem- +e ❑ OU-M (spectty) <br />❑ wharf <br />❑ shoreline <br />❑ abandon <br />❑ bridge <br />❑ obstruction <br />❑ install <br />❑ harbor <br />❑ rlprap <br />❑ channel <br />❑ watercourse <br />❑ said blanket <br />CT permanent dock <br />h11. MM M !Auer CM <br />$ <br />Build a piling dock to <br />moor a boat <br />JOSTFUTM (Explain why this project Is needed) <br />1'o moor a ooat <br />t1rliiiNig�Ji1 MM (kftJ s M C wVn to the hater and related land raources, lndudkV uwlavokWW Out dat'b1a1 W MJaCb) <br />-."A:' , <br />none <br />ALTEWTTtiU (Other alternatives to the <br />action proposed) <br />N <br />BEGIN VI <br />none <br />WATERS <br />1 hereby mxM appI1 r I m r/iu a lektnQOta SSat M MOW 105 17 ana all sUMOrt" rules Wr a perawt D wsnr n yr ems " MMM "wm. Ir v- -wu <br />ws4r(s) to - r ! I nor with all %*pWWV maps. plans, 04 Other Infar-nallm wubmitted with thh spplkalbn. The NO left s1r01aM and SIAM ante elelde <br />concerrung em eppkadon am tw and cared to go bM mY knowledge. <br />STATE OF Minnesota <br />rOtMTY of Hennepin <br />bs'almd and sworn b atkA in etas �f- <br />_1 L NY a !t1h it Va <br />Yh cols *Ww aghw Pet). 3, 19011 <br />ulsuIOultpn: <br />Whrd: DMR <br />JUDITH E. NICCUM NO: SWCD <br />1► NOTARY PUkJC - WtNNUOTA &w: Watershed Dftict <br />HENNEPIN COUNTY (3r'r4,*nrod: Ctt1► or county <br />wr —Rion Ever» F.e. a. 1901 Pink: army Corps of Engineers <br />canary: Applkartt <br />