Laserfiche WebLink
HF'F'-14—�G1G=��=� 1���--1 P'lIflhlEHHHH �_FEEI:: I,IHTEF"=�HEL� r�1�--1�1t=ir=,` F.�=t1 'G-�1 <br /> Pas#-it"° Fax�lote 7671 u�"" � �a9e�` I <br /> To � From �,t C � . <br /> � .�—� <br /> > <br /> Go,�DepL Co. i�r.-*��" '�' PG"�/LU <br /> Phr,ng n Phone K <br /> — Permit # n0- ��� -- <br /> f SHQR�LINE ERaSfON PRQTECTfON-�AST TRACK PERMIT I <br /> MINNEHAHA CREEK WATERSHEQ DISTRICT <br /> GRAY FRESHWATER G�NTER Ph: 471-t7590 <br /> 2500 SHADYWOQD I�OOP FAX: 471-0�82 <br /> EXCELSIOR, MN 5533� <br /> r�ac� <br /> �� ��C ����--�reside �t_�_�0 C� ��f O vl ��,�-�-�--'�� ' <br /> (Propert}� �ner) ' (Strret Address) <br /> �'(� 1_ 1� �� t , _ {�� ����'�,7� . «que5t ap}�rov�l to inst�ll <br /> �. � <br /> {�ity} (State) (7_ip) (Ph�ariej <br /> t (�� <br /> ri rat, shoref�ne erQsion protection on prope�ty described as�3�I� �r S�-4 �, �o��tef.� ir� <br /> � F-' �SfCZe1 �3 �.r?`ia� <br /> , � <br /> . Yhe rip r�p installdti�n <br /> (UVithin the Cily bound�ries) � {Cour�ty) {PID#} <br /> wi![ consist af �(� '�long th� shor�line of��'v��-'s'+, � �n full <br /> (lineal fee#) (Lake} f���y) <br /> accordance with the Mi"E�eh�l�� Cree�� V'Jatershed District Shoreline Protection Guideline for <br /> ri��ra� pl�eement requi� -d for issuance of a Fast �i r�ck Gen�ral Perrnit. I have contr�cted v��itl� <br /> ��� .. �._ <br /> �a (Narrie of Company} (Address) (Phone} <br /> � 2� �, to p�rForm the wark who is familiar with the technical requirements <br /> (6ond Nur��ber) <br /> and has fulfilied th� bonding requirements of the �rratersf��d district (see re�•.Jerse}. I h�ve read <br /> and unders nd the requireme�ts of the MCWQ relating tQ Shoreline �rusion Protection. <br /> �-� ��a <br /> �' (D��tej <br /> ` (Si �ati�rF �f Pro e wner) <br /> Subscrib�� anci sworn �a before me an this�� ��� +��y �f_,,.����� ���� <br /> /' ^�� � <br /> r <br /> �v_�1�._ - - /, � SAN�RA LEE KEt�]T��LLY <br /> Jotary Public \ t� NOSARYPISELI.r.-MI"INESdTA <br /> C µy ppMM�s5�0�+EXCIf�ES t�7-aGDS <br /> � � �— <br /> Approved By: <br /> ��� Date: t 3 d/ i <br /> I i <br /> �i���� _prn��rt-v[)��nzr _C:oniraclur _ Municipalsty _�Nlt_ _District Fiic <br /> TOTHL F'.i=�i <br />