HomeMy WebLinkAboutMCWD permit JUN-20-2003 11:08 MINNEHAHA CREEK WATERSHED 6124710682 P.02i02
Permit# -219
Sendblanket Permit and Sand Source Exhibit Form
FAST TRACK PERMIT
MINNEHANA CIREEK WATCRSNED DISTRICT(MCWD)
18202 MINNWMNKA BLVD, Ph: 962-471-0690
DPEPHAVEN, MN 55391 , Pax;952-471-M2
I,4 1 J swa L✓i✓1. reside at al d Y�i✓L� ® �' J7'f ,fie
(Property ownwi tAddtessi (City)
i4& A -Q'S/:oMqueet approval to install a sandblanket on property described
(stone,rip) z (Phone) '.
as � -9f:9Y&
located in O"ea Na
( o
-111�yz -Da7a1&_ ' p� 'aa,�aa s) (oc�rn)
(Properly ID 4(PIDIF]) PORTAMAMINU .
X,have conbvLcted with ,
InPI
R.MN iN 1..�_to install cl eann�sand from the
following sourcc e Wm. rn u,���� 4 �,rr Ruoff /l7,s/,
/ (S�+PpIkA ) Imo•$) ...._
one)
❑ I will install the sandblanket from the following source
(6upp�
( ems) (Cipr,6W9%AP) �J 0111-0)
My shoreline Is feet and the dimensions of the proposed sandb(ardwt are: X
Pno)
X Sandblanket dimensions cannot exceed a length of W(or 60%of shoreline),
(apaq MAdrhl
a width of 10' and a depth of s-. If this.project requires municipal approval or review, please attach
documentation of the municipal approval with this application.
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, 1 agree and understand that the District may war the property at reasonable hours
to conduct an inspection to determine whether the terms of the permit are being meL I further understand that
if t violate the terms and conditions of the permit Mat is issued based upon this application, the District shall
conduct a fletd tnspecdon of the project per MCWD Rule J, provided with this application. I understand the
District will charge fees to cover the actual costa of field inspections, including irnrasitgalion 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 Districts actual costs are deemed to begin=ruing when the District
issues notice of the vlola on to permittee. I have read and understand the MCWD Technical Guidelines for
sandtplank
!!e J'(
taus ot.Proptrr>,►ons
Su o e a ' sw to d e me on this til ,2021.
n..;ary P►mrc
V M
Public
b'Y Camnuziva FsWtK Jk 71,i005
A roved by: Dote
D
JUN-17 2003