HomeMy WebLinkAboutMCWD permit AUG-16-2000 12�56 MINNEHAHA CREEK WATERSHED 6124710682 P.02/03
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1VYYNNEHAI3A CREEK 'W�ITERSI�ED D�S'�RI� ��sT F�
Gray Fresi,water Foundat�on �G p . �� _
2SOQ Shadywood Road,$z�.�lsioc, NiN 55331 g � 0590
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S�ORELI1rTE EROSI � Y
ON ��tOTECTION- ��,ST TI�ACK �
I. � oN 1477`��Sp�/ residing at . .
(�'°pq�'Owncr) (8troct Add�ss - ,.— .—
� �'1�✓. .�'S39�. PH; �.�...���W3��!3. �eque9t approval t�inst�ll
(C;ty) (S�a�e,2tp7
ripcap sttareline erosion proceaia�on properry des�ed as , loca�ed in
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tC ' ' � +��7�Z'� � � � �y . The rip rap ins�allation
r) (Camry) (J'�De�a�tccl on t�K s�l�mai,)
will consist of�(o� -along tbc shoretine of , ,� � "` , in fu11 accordance wich
CCaneal fqet; Y�
t h e M s n n e h s h a C r e d E Wa t a r s h�D�strict S 6o r e line Prctoot�n G,�idcline for riprap placement required f�r
issuance of a.F r �t. I have contracted with
Minne�on��io�
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(Nana o�`c:o��""�' (addre�a) .' �. . .
lPhaie) � �
�'�� ' ,tv petform tlt�work who is famil�a�with the technical requirements and has
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Fulfi11 the nding cequi of the wacushed distt�ct(see reverse) . t have read an� understand �h�
� e o e re�lati�g co Shoretine Brosion Proteetion, � '
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s' u=e o�iC�i R (I�lt)
Subscribed an� swQrn io before me on this`$,�day of ��,.�gg'•a pq� ,
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Pubtic �� �
��pprovod H : �
y Do
lames t er,Diatriet Technician � ���
Dest,ibu�ion: I'ro[�r[Y Ou�r �pttrsetvr Muni�ipulity p� '
Dislrict Tilw
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TOTAL P.02
AUG-16-2000 12�56 MINNEHAHA CREEK WATERSHED 6124710682 P.93iO3
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SANDBLANKE'I'.,�ER�IIIIT & SAND SOURCE FXHYBIT FO�1VI
. CREEK WATERSHED DISTRICT �- �
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I�1'��`f��✓��O/�� residj,ng al f-���u--�7��'�������'l�i��'��✓' SS39'�
Pronarty 4wner Addness City,Stnbe,2in
�. -�irci�//� , �/ �'a3 a� Oo� ar I'ID#
wne Counry Township�Seclion,Renge (from ptopersy tnx s�etcFnent)
own and oeoupy the above siMg,le family residencc and wish to iastall a sandblankel on
/�1 r� —C.2ytrA�-
`��`&�'Y Mintie�ice Por�b�e Dredging
❑ I have contrr�ct�d with ����
C����at uddt+ess
to install elea.n sand from Eh� Eo114wing source:
c�ty�state,�in phOtl4
wM �Nd«c.�a a- ��.T7.��B fL�,G� /�N $S�'2�� � • �/ 7 � or:
SUpplier nddress ��honc �
❑ I will install the sandblanket myseIf fram the following source.
supplier
�
add�'ass ph�ne
If this projeet requires municipal appr�val or review, plc� attach documenl•alion of Ehc municipal appro��'
with this applicalion. My shoreline is Feet and the dimcnsions of the proposed sandblankct ar�:
�_ (Length) x �Q^ (Width) x�` (Dcpth). Sandblank�t dimensions cantlot exceed a
[cngth of 50' (or 5096 0[shorclinc),a width of 10'and a depth of 6".
! underscand lhat if this application is not eompletely filled out, or if t fail to submit thc rec�uired exhibits
the application is incocnplete and wil.l be ��etunlecL It will not be reviewed by MCWO staff until compl�te
By signr.ng this application, I agree and understand tha.t�the Oistrict may enter the properEy at reasonablc
hours to conduct an inspection to detcrmine whether the tcrms of•the permit are being met. I furthei
understand'thaE if I viola.te the terins•and condifions of a permit that is issued based upon this application
the Distriet shall conduct a field inspectiox�of t�hc project per MCWD Rule f, provided with this applicatior�
�[ understand the Distriet will eh�arge fees to cover thc:actua[costs of ficld i�nspections, incluc�ing investigatior
of the arca affectcd by thc work, analysis of the work, including tht services of [egal counsel and cn�ineers
and a subsequent mo '�ng of the work. The l�istri�E's actual c�sls arc; deemed to begin acccuing w'hez•
thc t tr' issue •ice of the violation to the permill�4. I have read arid understand Ihc Mc:WD Technica
G �d � s f ndblankels. •
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Sig atu op�rty owner, Dale
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S scribed and sworn to before me l•his �day of� 2�0�:
: . �, �,�, � � .
.
�
ary Public � . .. ..,;,�.,• .Woonr� �
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Approv and Acc�pted by Date
fames Hafner, Distxiet Technician