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FEB-25-2008 10�18 P.03iO3 <br /> . Permit# - 3� <br /> Sandbianket Permit and Sand Source Exhibit Form <br /> FAST TRACK PERMIT <br /> MINNEHAHA CREEK WATERSHED DISTRICT (MCWD� <br /> 18202 MINNETONKA 6LVD. Ph: 952-471-0590 <br /> DEEPHAVEN, MN 55391 Fax: 852-471-0682 <br /> . I, �Y1►'Yill/a �C�.2`�side at 3Qq� lUt�,-��•���r,�- �i- ,� <br /> (Pro�y�r� �a �i g� (Add�ess) (C tY) <br /> �Iv .� '�57 request approval to install a sandbianket on property described <br /> (State,Zip) hone) <br /> as .3c_'7�5 l�b���� � -� ���, �ocated i� _ Oron n , <br /> (SAeel eddless) (Wdhin the City bounderiee) (Caun <br /> on _ Lc�,�(t ��r,r�a�U - <br /> (Properly ID#[PIDt�J) (Lake) ( y) <br /> � hBVB Gpntr"dC�Wlth <br /> (Name of Compeny (Streetaddress) <br /> - to instalt clean sand from the <br /> (City, e,2i � (Phon <br /> foll�nring soun� <br /> M,� pPlier) i , � <br /> �„' �] � <br /> (Phone) <br /> I wil) install the sandblanket from the following source , <br /> (suppllen <br /> , , U <br /> (Address) (Clty,State,Zip) (Phona) <br /> My shoreline is�feet and the dimensions of the proposed sandblanket are: �_X <br /> ' -�� � (Length) <br /> �De�hj X�,. <br /> Sandblanket dimensions cannot exceed a length of 50' (or 50°�of shoreline), <br /> a width of 10' and a depth of 6'. If this project requires municipal approval or �eview, please attach <br /> dvcumenta�on of the municipal app�oval with this application. <br /> I understand that if this application is not completely filled out, or if I fail to submit the required exhibits, the <br /> application is incomplete and will be retumed. It will not be reviewed by MCWD staff until complete. By <br /> � signing this application, I agree and understand that the District may ent�r the property at reasonable hours <br /> to conduct an inspection to determine whether the terms of the pennit are being met. 1 further understand that <br /> if I violate the terms and conditions of the permit that is issued based upon this applicati�, the District shall <br /> conduct a field inspection of the project per MCWQ Rule J, provided with this application. I understand the <br /> District will charge fees to cove� the actual costs of field inspections, including investigation of the area <br /> affected by the v�rork, analysis of the work, including the services of legal counsel and enginee�s, and a�y <br /> subsec�uent monitoring of the work. The District's actual costs are deerned to begin accruing when the District <br /> issue�nakice of the tion to rmittee. I have read and understand the MCWD Technic2l Guidelines for <br /> sa la ' <br /> � ( ature of P rty <br /> bscribed and m to re me on this�_day of 20�. • <br /> �'� �,J <br /> ry �� � i� I`� , �'� � "�7 r� r-� <br /> i �� � �` <br /> ��• ' <br /> �1��_ � /i,, <br /> Approved by: . � <br /> � . <br /> TI"ITl11 D ri1T <br />