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NOV-29-2004 a8�39 P.02i02 <br /> _ : : . .. :�_::� , �-:��. <br /> �1� � ` I�I <br /> U• u" i.:� <br /> Permit � �� � 2 z00� <br /> �HOpELINE ERO�ION PRCJTEGTiON - �A�T T�aC�c PEaMIT <br /> MINNEHAHA CREEK WATERSHED OIS7RICT(MCWQ) <br /> i6�d2 MINNETONKA BLVD. PI�: 9g2�47t-0580 <br /> DEEPHAVEAt, MN 55391 F�x� 852-471-0682 <br /> 1, �Y/� B/ou�t� reside at 1390 C�i .ryr.� �la�-e� <br /> (Prc�peny Ownar) (S�ree�A dr�j <br /> _ ��Ovl c� ,�� 5�'�.✓��'', 'a�l� ��/ vZSSU request approval to install riprap <br /> (City) (Stato) (Zip) (i'hene} :� <br /> snoreline erosion protection on property descnbed as __�3_�ID CGIeI�/l1/�4C�2., located in <br /> ��oh v s�ree►�dd�ess, <br /> ,��,,,e _�8-jl7-23 3�- QO?.3 The riprep instaHation <br /> (WAhln the Ciry beundadea (Coun�~ (Propeny!D� �PID#�j <br /> wlll consist � along the shoreline of %'Jh � ,�vrfi1, �}'� in full <br /> �'�!(Uneal fBet) (Leke) (Bay1 <br /> accordanCe w�th the Minnehahs Creek WHterahed District $horelino Protaction Guideline for <br /> rfprap placement requlred fior issuance of a Fast Track t3enera�i Permit. I have contracted with <br /> ,t��'1hfr�Z�'rdl,�p��''�u�v/c QrPd�/i�T�V, �,C'�.sf'��/.fiov S�� i�7,��f�s y <br /> f Name af Company) (Sf{eet address) (Glty} (Zlp) (Phbno) <br /> .�, to perform the work who is larniliar with the technical <br /> (Bond Numher) <br /> requiremerits and has tulfiUed the bonding requlrements of tha wpttr�rsY�ed tiistrict(see pa�e <br /> two), { h�ve read 2�nd undarstand th.e requirements of the MCVUD telating to Shorellne Eroslon <br /> Protection <br /> 11 �`� <br /> (Slpnaturs � orty Ownorl I yL0) <br /> Subscribed and sworn � before me an this__S��day of , 2p� <br /> — - ' .�� <br /> _ - PAMF.LA J.01tV16v.11 <br /> IVoianj Publi ` y` Np1'qRY PyJ6llGMJNN�SOTA,. <br /> P�NNINCiTON CQ6fNTY <br /> MY COiWi!!.6XP.JAN.31�20l}:f <br /> Apptoved by: , _ Dat� � <br /> D1slrlbuUan: _Property Ownor _Conuactor __Munidpel'�r _ONR .,Distrid FUe <br /> Pa�e 1 oi 2 <br /> � � � <br /> TOTAL P.02 <br />