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. . , , <br /> NEW MULTIPLE DOCK, LAUNCHING RAMP, AND/OR <br /> '� � MOORING LICENSE APPLICATION <br /> ���, Lake Minnetonka Conservation District <br /> • - `- P-'r_ 23505 Smithtown Road, Suite 120 <br /> ''"�:'`°""" Shorewood, MN 55331 <br /> . <br /> � ' Phone (952) 7�5-0789 <br /> LMCD Receipt# ` �i/G-/-2 6 <br /> Because this form is to be copied,please use black ink or type. <br /> Pursuant to LMCD Code Section 2.03,a new multiple dock license is requested, in accordance with all data and other information <br /> submitted herewith and made a part hereof. <br /> ,�---- <br /> The person completing this form is th authorized ag ne r property owner(circle one). <br /> Applicant: i `. ���`�N�.� � <br /> Address: 3"�C� �C:� �S�re�t' <br /> City, State, Zip: O�(�`1� �f v �� �J 11% <br /> Phone: Ll1�2 '�� "y��Fax: <br /> �Rcrmrert,rv,,,�wnPr (if ciiff r rr , ���('�,t 1\(lvl (,�r p�� <br /> Address: I �C�_�'� ��C�`C,�C�GI�,�� . <br /> City, State, Zip: �(1`� �`���C:�, L�N ��"��� <br /> Phone: Fax: <br /> PROPERTY LOCATION: <br /> The property is located in the city of: r0 <br /> The property is riparian to LMCD bay/area(s): `� � �C,�y <br /> LMCD Area Identification Number(s): ��3 ,___ _ _ ._ <br /> � �-,�` i ',� � � �_=��r„�,.' <br /> �� �.t��� ' % <br /> l. Classification of user per Section 2.1 l, Subd. 2 (please circle one): (�, <br /> a) commercial marina d) transient (g�j private residence � MAR 2 5 2010 <br /> b) private club e) outlot association h) other(explain) <br /> c) municipal � multiple dwelling �y_ y � <br /> 2. Type of dock construction, describe and attach to-scale drawing: � Ca�►1C'�� <br /> 3. Please submit names and mailing addresses of owners within a 350-foot radius of the property. <br /> Such owners must be verified by checking with the Hennepin County Auditors Office, (612) 348-5910, <br /> (or a private abstract company) which can provide actual mailing labels at a cost of$1.25 per tax parcel <br /> (minimum of$25.00). This service usually takes two days, and you must have your tax parcel <br /> identification number (PIN) ready when calling for this assistance. <br /> Page I of 3 <br />