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a , <br /> Variance Application <br /> TOTAL FEE ENCLOSED...... (this fee is for processing of the <br /> application and does not <br /> entitle the applicani to a variance).................. $500.00 <br /> i certify that the information provided herein and the attachments hereto are true and correci; I understand that <br /> any variance granted may be revoked by the District for violation of the LMCD code. I agree to reimburse the <br /> District for any legaf, surveying, engineering, inspection, maintenance or other expenses incurred by the District <br /> in excess of the amount of the applicaiion fee. ! consent to permitting officers and agents of the District to enter <br /> the premises at reasonable times to investigaie and to deiermine whether or not the Code of the District is being <br /> complied with. <br /> I agree to submii a certified, as-built survey upon completion of the docks. <br /> � ��� � <br /> Authorize ' nature Date <br /> _ ��1� ��� C� 1njYl�Ct� <br /> T� le <br /> �/���.� �12f-�`y�� Return this application,attachments and fee to: <br /> Relationship to Owner <br /> Lake Minnetonka Conservation District <br /> 18338 Minnetonka Blvd. <br /> Deephaven, MN 5�391-3232 <br /> Fax: (952)745-9085 <br /> Page 3 of 3 <br />