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Z9'd "1ki101 <br /> � y . <br /> ,:,. <br /> r <br /> }•' <br /> . <br /> Permit# OU- <br /> �� SHORELINE EROSION PROTECTION-FAST TRACK PERMtT <br /> . MINNEHAHA CREEK WATERSHED DISTRICT <br /> GRAY FRESHWATER CENTER Ph: 471-0590 <br /> 2500 SHADYWOOD ROOD FAX: 471-0682 <br /> EXCELSIOR, MN 55331 <br /> I,�_ o.g�t�.Sce_�_reside at ��a oR� Sti�� �n�� <br /> (Property Ov►mer) (Slfeet Address) <br /> ���.�rno _, '�Ylrn, SS 3b� ,� +�1� - `dW(a request approval to install <br /> (City) (State) (Zip) (Phone) <br /> riprap shoreline�erosion protectior� on property described as Sa•�� ;located in <br /> (street address) <br /> ���,, , ��,�,.� � '��"1-11��.'a 3y o003 . The rip rap installation <br /> (Within the Cily boundaries) (Cour�ty) (P��#� <br /> will consiSt of�o along the shoreline of�k� . ��t � in full <br /> , (lineal ieet) �Lake) (BaY) <br /> accordance with the Minnehaha Creek Watershed �istrict Shoreline Protecfion Guideline for <br /> riprap placement requi�ed for issuance of a Fast Track Genera) Permit. I have contracted with <br /> QONC�BP'P I.ANGSCAPIN� <br /> 3158 PRIEST LANE , � (Pho�e) � <br /> a � y) � (Addr�ss) ' • <br /> � � , to�perform th, rk who is familiar with the technical requirements <br /> (Bo d umber) i <br /> and as fulfflle the bo in reqi�iremen�s f the watershed district (see reverse)_ I �have read <br /> . and u ers d the re u re f e CWD relating to Shoreline Erosion Protection. <br /> • <br /> : <br /> (Slgna oP Property Owner) � (Dale) <br /> Subscribed and svvom to before mo on his,_ a,g�'`' day of ���e.�e� � 2o�� <br /> , � ""-"'�, JAMES HAROLD&MITH <br /> a�ornpr vuauGecwt�sorn <br /> ',' . � �,�r cvomuuavow e�iaps,�i.�as <br /> Notary ublic � <br /> � Approved By: Date: <br /> � �stnbution: _ Owna ,rContractoe �Municipality _D _pistrict File <br /> Z0/Z0'd z890SLbZt9 Q3HS�131Fi1'�I >133`cl� dHdH3NNIW SZ:�Z z00Z—L0—f10N <br />