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THN—�5-2�0� 12��L� MIFJhJEHAHH CREEK WFITER�HED E,1��1�1�tE,82 P.�1�`01 <br /> � ��'—��/ <br /> MINNE�IA�.�-IA CREEK 'WATERSHT�D LIISTT�ICT <br /> �ray �'�eshwater Fouundatxon - Suite 37 - Ph; 471-0590 <br /> 2500 S�adywaod Road, �z�elsior, MN 55331 k`ax: 47I-4G82 <br /> S�i���INE ERtJS�UN �RaT'E�'I'�VN- FAST 'I'�.tAC� FE�tNI�T <br /> I, :�eX�,r�,��, .�h�.� ��a�,� � '��� C��o r� ��c�.. <br /> c�Y�') cstrxe A�3�esa> <br /> ��{t W 1 L�,J �� ' ��+�`J���VJ F,R.�. �+��~� I������ r�quest approval to ir►stall <br /> {Ciiy) (State,Zip) <br /> riprap shoreline erosion protection on prapeat�+described as `�i a�_ QX�C'�G�. �C�C�„� , located in <br /> �Y L�Yl C� ►�, _ �5 1("�, �3 �Q�o�? The r.ip rap installation <br /> (Cit!') Ccountyj (PID�toc�ud on tsx ste�emmq <br /> wil� cansist of �� t�ong ttte shorelir�e of YZ 1`�.� �� LI.�JiJJ . in f��l accordanae with <br /> (T,.ineat[eet) (L�e) f�aY} <br /> the Minnehaha CreeiC Watershed District Shprefine Protectian Guideline for riprap pIacernent required for <br /> issu.ance of�Fast Track C�eaneral�'e�rmit, I have contracted with <br /> Doc�a�,r� 1_i�'� , ��90 � ea�'or� �,ar�e. z�7��- 7��y <br /> (Nr�rne of CampanY) (Add[ess? (Ph�one) ? <br /> , ta perform the work wha ia familiar w'sth the technical requirements and 3�as <br /> (Bond Number) <br /> fulfiiled tl�e bonding reqt�irements di the w�t�h�d distri�(se�reverse) , I have rea.d and understand the <br /> rec{uirements of the WD relatit�g to Shoreline Erosion Protectsvn. <br /> ,.:. ... <br /> �� <br /> , 12-��� `�q. <br /> (Signahue of property aPwner) -- (Date) <br /> Subscn�bed and sworn to before rne an this � d�y a�' �'yY I9g'�tq <br /> 1 l'�r�n!�ir�._;�.s.r�^. GFFEIti <br /> VJf,�•'C� _i. ;,�,.�"F'IN;�i <br /> �.ehc. � - � " . <br /> ! shery�A. l.attemer .���.V �F �'.������1 <br /> �atary P !ic �,��-��� <br /> �+h cann+�wa„�..�an,a�,�000 �.�,�^� ;:_ .. �. ..., �. . , .;, .. � <br /> Approved By: " � �"�'' ' `�'"`,� �:�.. �.�:. ,... � '�`��; C.:�:.. �,�. <br /> J' es IIafner, istrict TechniGian (aete) <br /> Discributiat�; Proper�ty Owner Contractor Munieipelity DMi District Fil�rigineera <br /> fast <br /> TOTAL P.�1 <br />