HomeMy WebLinkAbout2006-MCWD permit 06-228 JUN-19-2006 14 58 M C u D 952 471 0682 P.02/83
Permit# % - ?2-
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, WILL , A1Lav& reside at I %%O f-1°,JrA ( iO
,, {,Property Owner) ,y (Address) (City)
1��1V
(Oa) 103- !o 3 request approval to install a sandblanket on property described
(State,Zi ) (P one ,
as PQM(') 1 GN uuw k_, located in O!'GNU , Waive.Pp)
(Street A ,� ( the City boundaries) (County)
d2-1n�3 l3-ool� on i'Vl1N/VG�7.'11'J , �(i�JE tL
(Property ID#[PID#]) (Lake) (Bay)
I have contracted with Docrt E/ 7. , / -0 5 „z.a.l,';:, O,',
(Name of Company) (Street address)
5�1, y P ,k
,, , A441 SS3' " (y5 4'71— t534/3 to install clean sand from the
(City,State,Zip iPnon
following source WHO I vl-e.I �( '� 604 Le, e 14' rte.n 11,011
(Supplier) ddress) (City,ZiloY
(9d) ) ' 1N--
(Phone)
I will install the sandblanket from the following source
(Supplier)
(Address) y� (City,State,Zip) (Phone)
My shoreline is /'5D feet and the dlimensions of the proposed sandblanket are: `ba. X
• �( /Q/ (Length)
(o X _ Sandblanket dimensions cannot exceed a length of 50' (or 50% of shoreline),
(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.
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
sandbink t
( igna ure of Property Owner) (Dale) jr� ��-a `� j 1
Subscribed and sworn to before me on this if t� day of 41-rOY).t6LAj , 20' ( �Ga L -� ioAfrillAii
ti ,_.110.11. SHERYL A. LATTERNER
t
Notary 1 r: :w'
rY Publi �►
NOTARY PUBLIC-MINNESOTA
My Commission expires Jan.31.2010
Approved by: Air/ f "`'�� Date