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LYJ O IV1U1 <br /> Permit# r' <br /> SHORELINE ER0310N PROTECTI4IV - FAST TRACK PERMIT <br /> MINNEHAWA CREEK WATERSHED DIStRICT (MCIAID) <br /> GRAY FRESHWATER CENTER <br /> 2500 SHApYWpOD FtOAD �h: 952-471-OS90 <br /> EXCELSIQR, MN 55331 �ax: 952-471-0682 <br /> � reside at ���3 � �ons,.��,,� �� <br /> (Property Owner) (S#reel Add ss) � <br /> ��� � <br /> ��'� , (�}�-_5-g�aa r�quest approval to install riprap <br /> (��Y) (State) (Z�p) (Fhone) <br /> shoreline erosion prc�tection on property described as 19`l3��p ,,,,, _.�,,,0 , located in <br /> �a (S addr s) <br /> T(Withln the City bvund ries (County) �� - -- ��p��I�n <br /> �S' (ProPerlY ID# (PID�J) <br /> wili cvnsist of �s� ��� the shoreli . <br /> 9 ne of.�7��v�, __,_ZU�'.��.__in full <br /> (Lineal feet) (lake) (gay) <br /> acoordance with the Minnehaha Creek Watershed Disfrict Shoreline Protectlan Guideline fo� <br /> riprap plaoerr�ent required far issuance of a Fast Track Gener�l Permit. I have oontracted with <br /> �.�(3�.�°�� _,�_�.1'1�0�. � �'r�.�,,._ �s 1 a � Gs�)�s�/- �/9.3,j <br /> (Nartl�af Company) (3treet address) (Cit�r) (Z;p) (Phone) <br /> . ,tc Perf�rm the work who is familiar with the technical <br /> (Bond Numbeh <br /> requiremeMs and has futfilled the bonding requiremerYts of the watershed di�trict(see page <br /> iwo). I have read and understand the requiremerrts af the MCUVD r+slating to Shoreline Erosion <br /> Protecti n. <br /> . - � . � � � S �o.a <br /> �' � Signahrre of Pro�ly Owner) r— <br /> , � (Date) <br /> ''Subscribed and swom to before me on this � � day of w1� 20 <br /> , �- <br /> � �� <br /> Nota ubli� AN7I�IONY D.SFIpP <br /> M�aR11 PUBLIC•1�OrK <br /> �C+aiei�bn E��n.ft,�q5 <br /> Approved by; ��� <br /> Date <br /> D�slnbWon: �Properly pwne� ^,ConUacto� _Muniapal�y _DNR _D1sUiet Fife <br /> i'age 1 of 2 <br /> �Bi�O'd z890ZLbZZ9 Q�HS�I�ld�1 �i�3�1� dHtiH�NNIW tiS:ZZ z0az-zi-�nr <br />