Laserfiche WebLink
_,�-.-,:"�`�� Yk�gdJVt/�lV�lv 1 l�t.)lv-ivIEJL!l�"fl.,�,x91.a4�8i LD�:�1�Jr,r�rra.���,�a a�iv <br /> - '�_ . , . �, <br /> Lake Minnetonka Conservation District � <br /> ' 18338 1Vlinnetonka Blvd. <br /> ' - Deephaven, MN 55391 <br /> ,�.. , <br /> - Phone (952) 745-0789 <br /> ,�j--- <br /> ----------------------- ------ <br /> LMCD Rcccipt# ' �/ `�" . _,... <br /> 7n accordance with Sec.2_06 of tlie LMCD Code,the following aPplication for a permanent Dock Liccnsc shall i�e <br /> completcd in alt respects and submitted to the District o�ce. No person may locate,�onstr�ct,install or maintain a <br /> new permancnt dock on the lake without first securing a license providing that no such license shall be required of <br /> docks rcquiring a license under sec 2.03 of the LMCD Codc.A new license is required whcnever the size,type, <br /> location,or eonfiguration of the dock is changed. No new license is required for repair or replacement of a previously <br /> permitted dock where such repair or replacement does not alter the size,tyPe,location,or configuration of che dock. <br /> Because this form is in he cnpied,please use black i�:k or type. <br /> The person coiilpleting this forni is the avthorized agent or property owner(circle one). <br /> Applicant:_ /�i��rrfinK4� �oyfa�%z �f�d,�i�fy� <br /> Address:__ .Sd� ���St�,�� �'fj�f- <br /> City, State,Zip: _ L�x�Ce�si���- /1/�/�/ 55�3/ <br /> Phone: `�52-1/7'f`�y.�'y Fax: °/'hZ- �7� �7/�- <br /> Property�Owner(if different from applicant): �7�P.9� �I"Crilhd,��/� <br /> Address //50 Q/c� C�'�SfT,t(�c�c� /��( <br /> .�-� <br /> City, State,Zip: ��4/1� /�l/tl SS3`I � ' <br /> Phone: �(��02-3/U�� Fax: <br /> Documents listed bel�w aze required; and must accompany this application: <br /> �Locator Map ❑Scaled drawing of docks ou abutting properties <br /> ❑County Plat Map �Proposed faeility site plan <br /> ❑Certified Land Survey,Legal Description ❑Exisring facility site plan <br /> 19bsetace of significa�it requested data, could result i�: a processing delay. <br /> 1. Type of facility �private ()inultiple dwelling <br /> ()eommercial () other(explain) <br /> 2. Intended use of dock facility �75��/MCI Q��.1 l� r=i%���vrL <br /> 3. AUutting property owners at tH�lakeshor�: <br /> Np�th or West � r7 f-I-�,�,�n� ��5 N. S l�u a�e l�a�� b r�»a M i� <br /> name and addr��s, < ( <br /> SouthoX�ast ����.ifev' Rc�►�u-�.�r "�/�S !1'. J�����1� I�►" V�l l�t� /✓�Ju <br /> nan e and address <br /> Other affecied parties <br /> :., neme and address <br /> . � of2 p [� C� � � dC� <br /> � JAN. 2r� 2005 <br /> . 8y <br />