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MAY-05-2005 10�07 P.03iO3 <br /> Permit#�$- /qS <br /> SHORELINE EROSIO�V PRQTECTIQN — FAST 7RACK PERMIT <br /> MINNEHAHA CREEK WATEf�SHED DISTRICT (MCWD) � <br /> 18202 Minn�tonka Blvd. � <br /> Deephaven, MN 55391 Ph: 95��71-0590 <br /> �ax: 9�2-471�0682 <br /> I, ' � � " � . reside at�y(� Gr���_���.���Occ� <br /> (Prope Owner) S atr et Address) <br /> ,((��t� , Pf'I I`? 5 " I, (�2)�}'1 I-�IZ'�� ►�qu�st approval to install riprap <br /> (Clty) (State) (Zp) (Phone) <br /> shoreline erosion protection on property described as�{� C�.tt.`'�i c�r� 4�.i 4�(k3�'� , located in <br /> (St et address <br /> ���(ll� � , I�I-��-23 y�k-�D22 . Theriprapinstallation <br /> (Within the City boundarles)� (Count ) (Property ID# [PID#]) <br /> will consist of �� along the shoreline of�inn �nk. ,��'C.� in full <br /> (Lineal feet) (Lake) �(B2y) <br /> accordance with the Minnehaha Creek Watershed District Shor�lino Protection Guidelfne for <br /> riprap placement required for issuance of a�ast Track General Formit. I have contracted.with <br /> �.�x�,-� �►� 1 r1 C_ , ��J JYvlXe.l�r� �I��� 5Df 1�0.��- ���J��- (�) 1- 3� <br /> (Name of Company) (Street address) ( ity) (Zip) (Phone) <br /> �J�`l���q ,to perform the work who is familiar with the techniCaf <br /> (Bond Number) � <br /> r�equirements and has fulfilled the banding requirements of the wate�5hed district(see page <br /> iwo). I ave read and understar�d�h�r�uirem nts of the MCWD i�elati�g to horeline Erosion <br /> Pro �, � �' J, / � �-�' <br /> � U5 <br /> ._ (Signa4,re Pro � (Daie) <br /> Subscrfbed and sworn o before me on this �n� day of ���.- . 20 OS <br /> � <br /> �'u' � ' ��� �� SHEF�YLA.LA7TERNER <br /> No Publi NpTpRy pU91�.INWNE9pTA <br /> , ARy CommleeMn 6�iee J1n.31,2010 <br /> Approved by: Dafie �/O�-1/� <br /> Distribution: _Pmperty Owner _Contrac6or _Municipalily _DMR Oistrict File <br /> Page 1 of 2 D ��� ti► ��%a�� <br /> c � <br /> ppR 2 5 Z005 <br /> TOTAL P.03 <br />