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MPR 2' 2001 15:00 MINNEHAHA CREEK WATERSHED 6124710682 P.02i02 5ANUt51.AIV1.CL t ru vui cc aru.4,-1 wvxnw," —•.••-L— ----�-- MAR ihgNNIUjAM EEK CRWATER'SMM DISTRICT res.ding at {Va Oa S , /u 0�!u ' properw Owner Addrtsa city,state,Zip- 95� Phone Co-vasty U Township,Scctiory Rage (from Property tax stalemrnt) own and,occupy the above single fancily residence and wish to install a sandblanket on tie&aay 1 1 have contracted with �6o nl C �,•-JSP a,,,M� at :ddrcw �r , I S's"3 k y , - Sa -,q,7.2 -4119 to install clean sand from the following source: city,stntq zip phone or. T supphe* Phone ❑ I 11 i the t yse the following source_ -- suppli�r P� if this project requires municipal approval or review,please attach documentation of the municipal approval with this application. My shoreline is ► 4 0 feet and the dimensions of the proposed sandblanket are: �o ' Qzngth) x 10 (Width) x (Depth). Sandblanket dimensions cannot exceed a. Length of 50' (or 50%of shoreline),a width of U)'and a depth of 6". 1 understand that if this application is not completely filled out, or if I fail to submit the required exhibits, the application is incomplete and will be returned. It will not be reviewed by MCWD staff until complete. By signing this application, I agree and understand that the District may enter the property at reasonable hours to conduct an inspection to determine whether the terms of the permit are being met. I further understand that if I violate the terms and conditions of a permit that is issued based upon this application, the District shall conduct a field inspection of the project per MCWD Rule J, provided with this application. I understand the District will charge fees to cover the actual costs of field inspections,including invcst�sort of the area affected by the work,a talysis of the work, including the services of legal counsel and engineers, and any subsequent monitoring of the work The District's actual costs are deemed to begin accruing when the District issues notice of the violation to the permittee, i have mad and understand the McrWV Technical. Guidelines for sandblankets. v0/ Sign ure of pro erty owner Date =.Sudsto before me this day of Iff lie 0 ` GEORGE W, JONAS 140 r1 F,1 'rl'GI IC MINti�SOTR Notary li _I d 3 Z2 Q A proved arld Accepted by Da c Tames Hafner. D1.4riet TPr�nini�n