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Permit#�� - � �3� <br /> SHORELINE EROSION PROTECTION — FAST TRACK PERMIT <br /> MINNEHAHA CREEK WATERSHED DISTRICT (MCWD) <br /> 18202 Minnetonka Blvd. <br /> Deephaven, MN 55391 Ph: 952-471-0590 <br /> Fax: 952-471-0682 <br /> I,�l� �e�i.�derm�_��reside at /u � f "i`I 1��'l'�``�VI�Gt �"t 1�1�I ��L2Gt ��l <br /> (Property Owner) (Street Address) <br /> � ,�� `�(—) request approval to instali riprap <br /> (Ciry) (State) (Zip) (Phone) <br /> shoreline erosion protection on property described as � �Cl , located in <br /> (Street address) <br /> �� , �Y� �' , 6�"I I'� 'Z���bn //. The riprap installation <br /> (With the City boundaries) (County (Property lD# [PID#�) <br /> will consist of 6` along the shoreline of��`1i�1 n�n k� ,1���SI/� Lt,I/yh in full <br /> (�ineal feet) (Lake) (Bay) <br /> accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for <br /> riprap placement required for issuance of a Fast Track General Permit. I have contracted with <br /> �l I(.o1 / j �� � �.9� ��.��19M- 5����- `-�'7���S� <br /> (Name f,Company) Street address) (City) (Zip) (Phone) <br /> ( a � �� '�- ,to perform the work who is familiar with the technical <br /> (Bond Number) <br /> requirements and has fulfilled the bonding requirements of the watershed district(see page <br /> two). ! have read and unde�stand the cequirements of the MCWD relating to Shoreline Erosion <br /> Protection. <br /> ���^-• � � - � � �� <br /> (Signature of P Owner} � �� (Date) <br /> Subscribed d sworn to before me on this � day of_�' �'��� , 20�. <br /> ..�-----. �.�,.� <br /> otary Public ,;�°� �";--. Thomas C. Niccum <br /> - ` Notary Public <br /> =� ;�� Minnesota <br /> --,�::,,„..,. <br /> Approved by: r� Date �Z l l0 <br /> Dist�ibution: _P�opeKy Owner Contraotor _Muniapality _DNR _District File <br /> Page 1 of 2 �i``' _ <br /> � <br /> �Ay 212010 <br />