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FEB—�S-2005 1��48 P.a2i�3 <br /> � U`�` �� ' <br /> � ����� <br /> �== <br /> �-�✓ Y. � Z.UUJ <br /> Permit # - <br /> SHORELINE EROSION PROTECTION — FAST TR CK RERMIT <br /> MINNEHAHA CREEK WATERSHEO DISTRICT (MCWD) <br /> 18202 MINNETONKA BLVb. Ph: 95�-471-0590 <br /> DEEPHAVEN, MN 55391 �ax: 952-471-0662 <br /> I,�-�n.��Y� �v p �eside at O C � c> a � �. +-- � <br /> (Property Owne�) (Strest Add�ess) <br /> _ OYov�U , �Z �39/ , (9�2) - � 3 request approval to install riprap <br /> (City) (State) (Zlp) (Phone) <br /> shoreline erosion protection on property described as �9�l�S�r����nt a r� , located in <br /> (Street address) <br /> ��.f��r�.0 ���� aa-ll7- �3��-��.5'� . The riprap installation <br /> (VUithln the City boundarles) (County) (PropeRy ID# (PID�J) <br /> will consist of �d along the shoreline of ,i n>. � in full <br /> (Lineal feet) (Lake) ay) <br /> accordanae with the Minnehaha Creek WaYershed Dlstrict ShoreOine Protection Guideline for <br /> riprap placement required for issuance of a Fast Track General Permit. I have cont�acted with <br /> r � s , 8 l�� �- U•��t�uF.S. ��v�� ��z b��� <br /> (Name o Company) (Street addresa) (City) (Zip) (Phone) <br /> �. � � G �_, to perform the work who is familiar with the technical <br /> (Bond Number) <br /> �equirements and has fulfilled the bonding requirements of the watershed dist�ict(see page <br /> two). I have read and understand the requlrements of the MCWD relating to Shoreline Erosion <br /> Protection. <br /> f <br /> �.��,..�-, �� ��-�' � - iy -o s <br /> (S{gnature of Property Ow er) � (Date) . <br /> Subscribed and sworn to before me on thls,� � .�( , 2Q5�. <br /> �,�Q�` Z MARCIA JO YMAUdK(iF . <br /> Notary ubl c ����'�U <br /> wr oo..s�m ra�a�m.a�,aoo► <br /> . ■ <br /> Approved by Date �f I 4 j c1s <br /> Distribution� �Proporty Owner _„Corrtractor _Municipality _bNR _Distrid�Ile <br /> Page 1 of Z <br /> � <br />