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,t-It'''brand fax transmittal memo 7671 1 d of pages ► 1 p p z ,y r 1 r ,v <br /> 1 --q . <br /> Dept. 7 /} } Phone % es <br /> fagtx N �!3�Ll--�/" fax�97 7/- -- PERMIT <br /> . ,. �,.:/l\,.%A1l A <br /> { " MINNEiAHA CREEK WATERSHED DIS RI <br /> CT <br /> }. SHORELINE EROSION PROTECTION <br /> 1. � wr <br /> tS?55 K rth S re rive , <br /> 1, <br /> ,A residing at „_ (Street) <br /> 0. — <br /> (City)• (State) (Zip Code) (Telephone) <br /> :< <br /> request approval to install riprap shoreline erosion protection on property described s in <br /> above 07 117 23 <br /> Henn. ; <br /> •; Orono 114 Section) (Section) (Township) (Range) <br /> ` ' (County) <br /> . (City) <br /> installation will consist of3 (lineal feet) along the sltbtelint of <br /> f �: • The West �1r�i-Lk.Mtk a. (Lake), in full accordance with the technical g . <br /> ';'. V of the Minnthaha Creek Watershed District Shoreline Ere sion contractedction with Guideline, as <br /> ���.�. published) required for issuance °�".��• <br /> of Company);of of a general permit. T have Lake t;,� r- <br /> .c.,�,sic - (Address); <br /> . Mt:.4.117.9.L$5.4,—• <br /> 454 } (Telephone);; g4-flib (Minnehaha Creek Watershed District <br /> e <br /> f; icense No. to perform the work who is familiar with the techWatni l Disrements. 1P and <br /> hoc <br /> •1 read and understand the requirements of 1innehaha kmy Contractor. <br /> M, as amended, and have provided a copy of the rules to <br /> (Signature) <br /> . ---�' --' (nate) <br /> y Feb. 199 . <br /> Subscribed. and sworn to before me this <br /> 28th. da of <br /> 01 <br /> J1 y/ . •/ ~ . . s 0.rsi <br /> 1. <br /> : otary Public 11.31-2004 <br /> • <br /> Ap,r.ved b ,\ l <br /> la 4 L i I �� A. <br /> (Date) <br /> . Minn!:° aha Creek Watershed ti4.trict <br /> April 19, 1993 <br /> 5i <br />