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�1'�E�HA � <br /> . -► ,� `�'t <br /> f '� PERMIT NUMBER <br /> • �je�' ��� <br /> � �EO U�S <br /> OATE RECEIVED <br /> MINNEHAHA CREEK AGENDADATE <br /> W ATE R S H E D D 1 S T R 1 C T APPLICABLE REGULATtONS <br /> P.O, Boz 387, Warzata, Minnesota 55391 <br /> See reverse side foc instructions Do not write above this line <br /> 1. OWNER: k>>rt Car �on ____ 2. APPLICANT: ��tka. Portable Dredgin� , <br /> .:...w� <br /> ADDRESS: �2� ('a�;c� (;i rcl � ___ ADORESS: 5�� �"J. Lake St. <br /> CITY: �;���a±.� ziP: _�5��1__ ciTY: Excelsior QH4n,�: 474-9454' <br /> ,�� :; <br /> �. PNONE: 4T��$�T( SIGNATURE:� -���f.�r t-c �-' - <br /> 3. O Preliminary plat review �X�horeline Improvement o�Rip-Rap <br /> O Grading/Drai�age Plan O Shoreline Setback Varla�ce for <br /> ❑ Bridge,culvert, or utilities Prope�ty Improvement <br /> ❑ Flood Plain Development O Fill or excavation <br /> O Use and app�opriation oi O Permit Extension <br /> Public Waters ❑ Other <br /> , Describe work and objectives: Place natural field stone rip rapp along <br /> �A—�t. of ShnrPlinP to �rotect against erosion and beautify it. <br /> 4. Project location: ����g_���2��� {�nnq l ot 1 � & 14 <br /> 5. Current status with other applicable agencies: 5ent t� nrono <br /> 6. eody ot wate� attected: Carmans I3ay — Lake Minnetonka <br /> Call 473-4224(or asslstance In completing thls(orm. <br />