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_ <br /> FEE—�c-1'�'=�� 14�4�=; I•l I f lllEHHHH C:F'EEI':: I:,:Ii=�TEF°-�HEI! ��1�4�it=�r_�� F'.t=�1 'G_r� <br /> ;.: . . <br /> �7— 39 <br /> I���NN���A�A C1�EK WATERSHE�] DX�T��CT <br /> Gx'�y �'�reshwater �'ou�ndation - Suite 37 Ph: 471-4590 <br /> 2500 Shadywood Raad, Excelsior, N�N 55331 l��'ax: 471-06SZ <br /> SHO�tELINE ER(�SIQN PROTECTYQN'- �'A.S'�' `�'�.A►.CK PERMIT <br /> I,�a� �n e��f� r+�siding at ��]�',� �c�-.co �O��a� <br /> tr���y o���} �s���Aaa�-�� <br /> ��Q , ���. p�; ��/ J -7 7n$ , re�uest approv�.l to ic�stall <br /> (c�tY) (State,riP) <br /> riprap sl�oreline erpsion protection on prpperty descnbec� as �a.,�..- , located in <br /> (Street Address} <br /> ��.,� , �.�.,,� �a - }�� �- �3 �.3 -. oo�- The rip rap installation <br /> (Gity) (County) {PID# located on taz statcmcnl) <br /> w�ill c:.onsist of !v o along the shorelin� of �'1'l�r�c�t , �p .{���� , in ful! accordance tuith <br /> (Lineal feet) (La1:e) (Bay} <br /> the I��'Iinne�a�ia Creek Watershcd District Shoreline Protection Guideline for ripr�p pi3cement r�quired for <br /> issuanc� of a Fasi Traek General Permit. I have contracted with <br /> ----�-,y�--w•-�----- ..... <br /> � [�CNG'�'`LJ�I�IDSCAF�INQ � ��--, <br /> (Ngmc_oCC��'���T ��� (Adclic-ss) . lPlionc) . <br /> ;,;�MOUNO� I�IN 6�3�4 � <br /> ` �" ' �_to pertarrr� the r�vark who is fan�iliar ���ith the technical rcquirctnents a��d k�a� <br /> {Bond NmnU ) <br /> fulfil�ed the honding requirements of ttle waters�ied district c see reverse) I have read and uncicrstand the <br /> rc�uirement..� . MCW relati�lg to Shorc;lir�e Erusion Yrotection. <br /> Iv}INIVEFila{;�+ 1=;���K <br /> � - � WATEFfSME[� C}IS'1`RICT <br /> � <br /> (Signalttrc ol praperty owt�e��) (D�tcl <br /> F�� z � � <br /> Subscribed and sworn to betore me c�n this ay� day of , 1997_ �-��, ,;: �„ ,� � <br /> � � �� �� � �:� � � <br /> .o..�..r.�.4....�.....�...�a�g.,..,�..., � . <br /> � � ,a�;����^e-�.��.��.,4�E:+sd.�s�'�a <br /> . , <br /> , ;.. <br /> �y�l .++'A�� nrJ{ZjaFi ^�.inR�L�e.C1/�C^,�cd1;��_{y,^-��'ii.4 <br /> � _-�� C`ll"��il�r''�4' t-JL�I�iWY'�IIY I�VV�V E i <br /> Nat ry Public """� M:•''.�=rf�m;=tilGn tl),7lfea i-�'i-200(1 <br /> �w..,.,..�_..,,...... <br /> Approvec4 By: �'2�4�� <br /> Suza ne VVeedn�an, Assist�nt Directar �Pt�rz� <br /> 1)ist�ihuiton' Property f)�vitcr Co11t1�ctoY Municipality L3NR L�istnct FiJe/�ngin�rs <br /> fast <br /> ., <br />