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(PART B-7 Cont.) ''�
<br /> __-:�_.. V. APPLICATION FEE: ❑�FS?t)p attached.
<br /> _::��- NO ACTION WILL 8E TAKEN ON THIS APPLiCA710N UNTIL THE FEE IS SUBMITTED.
<br /> NOTE: Application fees are not refundabie,even if the application is withdrawn or denied. (
<br /> VI. ENVIRONMENTAL PROTECTION:
<br /> Have the appliqnt's daign snd construction personnel read the Depanment of Nsturel
<br /> Resources Rules and Regulations NR 5102? � Ya ❑ No
<br /> VIt. ENVIROfVMENTAL CRITERIA: •
<br /> • � Part B•2 has been completed and is attached: Ii not,explain when Part B•2 will be submitted.
<br /> NO ACTION WILI BE TAKEN ON THIS APPLICATION tNITHOUT SUBMITTAL OF PART B-2.
<br /> Applicant deClarts that iniormation submitted herewith and statements msde herein are a true and correct representation of the facts,
<br /> and that the filing o/this application and information with the Commissioner of Natural Resources is prima facie evidence of the correctness
<br /> thereof. .
<br /> VI11. Underwater crossing(s) only - IX. ACKNOWLEDGEMENT:
<br /> THE COMPLETE APPLICATION HAS BEEN SUBMITTED TO: 6th March
<br /> Orono MN. Dated this d�y ot �g 87
<br /> (�) Mound,� MN.
<br /> N.me ot acy or townsn;p AppliCant E H Schentzel
<br /> (2� Minnehaha Creek Watershed District (P���l or type name)
<br /> N�rtx of Weter�heC O�strict $igned by
<br /> � - � Pret�oent
<br /> (3) Shoreland Managemtnt Administrator � -
<br /> Signed by E H Schentzel
<br /> of Hennepin ��
<br /> _._ County 414 Nicollet Mall
<br /> Address
<br /> Minneapolis, Mn 55401
<br /> ^State of Minnesota ) • AFFIDAVIT
<br /> Hennepin � �
<br /> County of ) (Delete the affidavit form not applipble)
<br /> 6th March
<br /> On this • day oi , 19 87 , �fore me personally appeared
<br /> —� H S�hQntzPl. Administrator Re�ulator Liaison ,,,,ho being first duly sworn and to me known to be the
<br /> person_ who executed the foregoing application, acknowledge that the statemenu, maps,plans,d�cuments,and other supportinp
<br /> data are true and correct according to his �n knowledge and bel�ef and that he executed the same as
<br /> his �,�,n fre�e sct and deed. �
<br /> E�irtrt;
<br /> and , rsonally known,
<br /> who being each by me duly sworn,did say that they are respeaively the resident and the
<br /> Secretary pf the corporation named in the foreooing instrum e seal affixed is the corporate seal of sa;d corporation, that
<br /> said irrstrument was signed in behalf ration by authority oi its F3oard of pirectors, that the statements, maps, plans,
<br /> documents, and �ng data are tiue and correct according to__�st knowleoge and belief,and acknowledged
<br /> •M.i,r_.:'JJ./��.�J.n/�/J�V���l.M/�,�•.1^✓�,�n n.,�nn w
<br /> ( ;r` r . LJE�t:: �':. i!`��;.QY � .
<br /> ���3`..��'; P=�C:T:,�,Y PUEII�"-�,i!.:NE�nTA "
<br /> ` �` H��`"`f�i" ���`:,;,` Notary Public Hennepin
<br /> � County
<br /> . ;:.,� Cc^���ission Exr•�`c;QcL 16, 1£R;; �
<br /> � .
<br /> b ;,,,,. ,,,�,�v�n�nn�vw`�.v:^.:ti^.vrn�,�,-t October 16 I�0 88
<br /> . My commission expires
<br /> X. APPLICATION PROCESSING:
<br /> -�::� Submit application,application tee,maps,plans,specifications and other supporting data to:
<br /> BUREAU OF LAND
<br /> DEPARTMENT OF NATURA�L RESOURCES
<br /> Centennial Office Buildirtp
<br /> St Paul, Minntsota S�v155
<br />
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