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.�.. �i <br /> � Permit # - <br /> SHORELINE EROSION PROTECTION - FAST TRACK PERMIT <br /> MINNEHAHA CREEK WATERSHED DISTRICT (MCWD) <br /> 18202 MINNETONKA BLVD. Ph: 952-471-0590 <br /> DEEPHAVEN, MN 55391 Fax: 952-471-0682 <br /> i, ��f1o��t� �/���f C. reside at �v /� C�5C�6 �Gf' �d� . <br /> (Property Owner) (Street Address) <br /> C�C�v�a , IM.� ��� c�� %���s`�g`l , ��� %��/-� �� z <br /> (City) (State} (Zip) (Phone) (Fax) <br /> (1�c�c�de('��,S�ut�(�`+11e�request approvai to insta{I riprap shoreline erosion protection <br /> (email) i���"" ` " ` �� <br /> on property described as ��"�' , located in t ��� <br /> (Street address) (Within the City boundaries) <br /> ��\ _,Z,Q�j� 7-2�3-���••DD�S�. The riprap installation <br /> (County) � (Property ID# [PID#]) <br /> will consist of�along the shoreline of p�����^ , 5p�`YV f��� � in fuli <br /> (Linear feet) (Lake) T(Bay� <br /> accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for <br /> riprap placement required for issuance of a Fast Track General Permit. I have contracted with <br /> 1�fb,� Patb- �c�s� , �ao w�5�- ��� �',c� 653.�� �U y�y�f�sy <br /> (Name of Company) (Street address) (City) (Zip) (Phone) <br /> ,�— t ( <br /> /� G �'�., , to pertorm the work who is familiar with the technical <br /> (Bond Number) <br /> requirements and has fulfilled the bonding requirements of the watershed district(see page <br /> two). I have read and understand the requirements of the MCWD relating to Shoreline Erosion <br /> Prote ' . <br /> �� � <br /> ign ur r•e�e er) ��` ^ (Date) <br /> r� <br /> Subscribed and s rn o be re me on th' �'�, � r, 20�. <br /> es C. � <br /> NMery PubNc . <br /> a lic �n��� <br /> '-„ � MyCart�s}on E�IrosJanu+iY 31,2011 <br /> 1 <br /> Approved by: � Date i� `� <br /> Dlstributlon; �Property Owner `�Contractor �Munlclpatlty _DNR V Distrlct Flle — _. _....._ _ <br /> Page 1 of 2 — � --C� �C� .�, �.I ��� i`._� <br /> � SEP 1 7 201?_ <br /> �y.�. ___._.,..M_y_..� <br />