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G <br /> � j <br /> � ,'USE A TYPEWRITER OR A BALL POINT PEN WHEN COMPLETt1�G'.MIS WtW.IF YOU ARE PRINTIN6,PRESS NARD SO TNAT ALL COPIES CAN BE READ. <br /> � • ♦ <br /> DEPARTMENT OF ' /�`�v NA-026740d <br /> � J�,�4� . Rev. 4/81 <br /> � �NATURAL RESOURCES LOCAL UNIT O�OVERNMENT COMMENTS <br /> • PART B <br /> Section I (To be completed by applicant) <br /> Name of Applicant Street, RFD, Box No., City, State, Zip Code) <br /> R.F. Oo�log & J. Flatz 106 & 1058 Loma I,inda Mound, Mn. 55364 <br /> Quarter Section(s) Sectbn(s) Township(s) Range(s) Counry(ies) <br /> PROJECT LOCATION N2 8 117 23 Hennepin <br /> Project will affect: (name and number of take, wetland.or watercourse) <br /> North Arm La�e Minnetonka 22 � � <br /> I hereby submit this application for permit to: Signature of Applica Date <br /> (mark proper box) <br /> �appropriate water �work in protected waters X���� , .c'� A i � <br /> ------------------------------------ ------------------ <br /> Section II (7o be completed by local unit ol government) <br /> The tollowing local unit oi government comments and/or recommendatlona are submltted for conslderation by the <br /> Department of Natural Resources�ln the disposltlon ot the referenced permlt appllcatlon. (YOUR RESPONSE MUST BE <br /> SUBMITTED TO THE DNR WITHIN 30 DAYS.)Water Approprlatlo�Permlt Appllcatlons are to e sent to the Central Of- <br /> fice,St. Paul,and Protected Waters Permit Appllcetlons to the DNR Reglonal OHlce.SEE REVER3E SIDE FOR CORRECT <br /> MAILING ADDRESSES). <br /> P�.� ��� � � ��'` �- ��:.�` <br /> �� � �-- �,,,�.},�— �.,�— � ���,,o � � �. <br /> � . <br /> Was the proposed project iield inspected by this locat unit of government? (�IO DYES (if Yes, give viewer's name) <br /> Viewer's Name Titl� <br /> uthorized Signature Title Oate Telephone No.(Area Code) <br /> (,� , /yy� ..2 S- I- �S (b na y�3— 7 3 S <br /> Name of responding Soil and Water Conservation Dlstrlct, Watershed Olstrlct, Clty or County <br />