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APR-24-2002 13�35 MINNEHAHA CREEK WATERSHED 612471a682 P.02iO3 <br /> �- - - o�- tak�v <br /> � SANriB�AI����'��.&,SAl� SOURC��£XI3IBTT FORINX� � - <br /> 1Vl C�EEK WATEB.SI�D l?LSTIUCI' - <br /> � "" PERMIT�Q_I � <br /> �,��C�--t-�m._l. L��s�E y�s;a;n� ac �/os- ����oeo�A rl�r��.✓a rn.� ���. <br /> - _ <br /> Proper'ty Owtter .. AQdTtEs City,StaFt,Zip <br /> �� ? �f�. � , or PID# -117,=?., —�=,d(Ji <br /> Pl�ane CouidY 'row����4 R�S� (from p�vperty lex slnle�cr�t� � <br /> �. . <br /> own attd vaaitpy the above sir�gXe l�mi�y�aidenoe an,d wish tn install a sandb�ankct an � <br /> ll'1 r� • — �f.� �'P�r� <br /> u�oe et esy • <br /> �I ktavo oorttt acted with ae <br /> Mlnnetonka Portable D g ng ��� .� � <br /> to install cican satid from t(te fa[lowin,g sour� <br /> �`� � MN s�i pho� <br /> oe s�or, � <br /> - a�d,sa.� (� rn, .L�1 r,�,�z�,� , rgdr � � /�1/✓' y��� �/�T�or. <br /> supplier addmss phonc <br /> ❑ I will install the sandbl�nk�et myself fmm the follawing saurce_ <br /> � <br /> �+� <br /> add�eas phonc <br /> If this projecE ret{uit�es munieipal appc�wal or review,plesse at�ls�ch docum,enEation of the municipal appra <br /> with this application. My slioreline is.�_Fcet and th�e dimensions of Ehe proposed sandblartkct are: <br /> �_ (Ler�gth) x _ .�6 (Width) x,�._._ (Dcpth).Sandbtank;�t dimensionR cannot exceed a <br /> length of 50' (or So96 oF shoreline),a width of 10'and a depth oF 6". � <br /> I undetstand that if this applica.ti�on is nvt campletely filled out, ar if I fail to submit the t�eQuired exhi� <br /> the applieatiori is iacomplebe attd will be return�.,It will not be reviewed by MCWD sraff until oompl� <br /> By signi�t�g fihi8 applicatio�t, Y agree and �deratatt�cl that th�e District �y enter thc property at �easone <br /> hovrs to eanduct an in.specti,or► to deternaine whether thc terms of the permit are being met. I furt <br /> andersFa.nd'th�t iE I violate the ternis.and eox�dittioxts af a permit th�t is issued. basr.d upo� this applicati <br /> rhe Distri,ct a�all'eimduct a field istspeetion of t!u projeet per MCWD Rule j, proovided with this applicati <br /> I understsnd fke Distriet wt�1.charge fees tn ooycr the�ctual oc�s of tield inspeetions,includir�g investigai <br /> of the area affcctr.cl by thc work,analysis of the work, i�cludiqg the se,rv' le�gal coun�el :nd er�gine <br /> , and any subsequent moniboring of the vwrk Th� District's actual co6sls�,neu� to beg�n aceruing w: <br /> the DisErict issues n ' e af thc viol�tion to thc permittee_ i have tead and understand the Mc�WD Te�hn <br /> ide � es�or san lanke <br /> . . � <br /> -; , � ,� � <br /> � ar� <br /> .. _ <br /> Su,bscribed and sworn t�o befo me this ��_�ay of���.200,?+- �ud�n E� <br /> . � ---�• ;� �a►�yP���-Mrr�oer <br /> . . M'���r.��t,�dos <br /> N Public . � . ,�,�c. . . - <br /> ��� . ,. ' �� <br /> Approvcd and Rcc�pted by pa <br /> •_ . _ rr_� r+'.. • . �► � � ' <br />