HomeMy WebLinkAboutMCWD permits p ECSC YE
NOV 0 8 2010
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Permit# I
Sandblanket Permit and Sand Source Exhibit Form
FAST TRACK PERMIT
MINNEHAHA CREEK WATERSHED DISTRICT (MCWD)
18202 MINNETONKA BLVD. Ph: 952.471-0590
DEEPHAVEN, MN 55391 Fax: 952-471-0682
I, Stew. ?uO (� resideat 5503 t,alc e.J Dry
(Property Owner) (Address) (City)
mo 55 y 7-. q(_? 6-L33 request approval to install a sandblanket on property described
(State,Zip) 4_(Phone)
as J u/ 7'o,\)1c,aJ�n a. v( , located in 01^oAJc)
Street address) Within the City boundaries) (County)
G'j5-1� y-! on jLtV.�� _ �1u
(Property ID#[PID#]) ,, (Lake) p (Bay) r j
IZ1 have contracted with �U�t ('(i A Ok(J� y\ � S(�) cie64- k,
(Name of Company) (Streetaddress)
6(C-e,16 6533 l ("S ) 1/2Y tYV to install clean sand from the
(City,Sta�teZip) (Phone)
following source [a!iWl A4u t,i i ctc{u `c
(Supplier) (Address) (City,Zip)
(Phone) S
I will install the sandblanket from the following source
(Supplier)
(Address) hh (City,State,Zip) (Phone))
My shoreline is OV feet and the dimensions of the proposed sandblanket are: 2 J X
xx (Length)
(c^ ' X v Sandblanket dimensions cannot exceed a length of 50'(or 50%of shoreline), j
(Depth)
Width)
a width of 10' and a depth of 6". If this project requires municipal approval or review, please attach
documentation of the municipal approval with this application. j
I 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 the 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 investigation of the area
affected by the work, analysis 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 permittee. I have read and understand the MCWD Technical Guidelines for
sandblankets. -7 (/
,b f 10
(Signature of Property w 73r) (Date)
Subscribed and sworn to efore me on this �� da of ,20 j
�"� [,*L MARY JEAN WHEELOCK
o Public ARY PUBLIC-MINNESOTAc),mision EKpiroa Jen.91,2011
Approved by: Date 0
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1 Q _ 2Perm t
SHORELINE EROSION PROTECTION — FAST TRAC
MINNEHAHA CREEK WATERSHED DISTRICT (MCWD)
18202 Minnetonka Blvd.
Deephaven, MN 55391 Ph: 952-471-0590
Fax: 952-471-0682
reside at 5S63 C6,kcu"e, 64.
(Property Owner) (Street Address)
67c,`,e Vrt h j.Sy2 (I`LZ) W�—4 263request approval to install riprap
(City) (State) (Zip) (Phone)
shoreline erosion protection on property described as 22 V �i0 h ��`�'`` I2G6 located in
f t Street address
6��m �7C v�v� , o.5-�� 7` 2�— 3`/`0011 The riprap installation
(Within the City boundaries) (County) (Property ID# [PID#])
will consist of Sly along the shoreline of )A4'k `s �U k)l-)-S in full
(Lineal feet) (Lake) (Bay)
accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for
riprap placement required for issuance of a Fast Track General Permit. I have contracted with
4A 1�4. n�� ®14�rZ DCJ Ve_s kk lac. � 1 (5%3•z) /2� -9 s�- /
(Name of Company) (Street address) (City) (Zip) (Phone)
° �f- , to perform the work who is familiar with the technical
(Bond Number)
requirements and has fulfilled the bonding requirements of the watershed district(see page
two). I have read and understand the requirements of the MCWD relating to Shoreline Erosion
Protec�on.
AD
(Signature of P perty Owner) �)n (D te)
Subscribed and sworn to before is day of—�/ ' � 20j
"'°A,Nai.,_jynn easil•Niccum
Notary I Rotary Public
Minnesota
CommissionEKp4esJanuary31,2012
Approved by: Date kt 11., 16
Distribution: _Property Owner _Contractor _Municipality _DNR _District File
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