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� � i <br /> 1 q � <br /> Permit # -� I <br /> SHORELINE EROSION PROTECTION — FAST TRACK PERMIT ' <br /> � <br /> MINNEHAHA CREEK WATERSHED DISTRICT (MCWD) I <br /> 18202 MINNETONKA BLVD. Ph: 952-471-0590 <br /> DEEPHAVEN, MN 55391 Fax: 952-471-0682 � <br /> I,d�.au�l� �W�,�I P reside at ��v�y �C��GO �d r��' ��'�'"� <br /> (Property Owner) (Street Address) <br /> �c)���2���'L , �� . S5 ��l , c9� y�i��.���P , ,�i y7Y�E)l2. <br /> , <br /> (City) (state) (zip) (Phone) (Fax) <br /> request approval to install riprap shoreline erosion protection <br /> (email) <br /> on property described as ����-� , located in �L/G��Zq d�� , <br /> (Street address) (Within the City bpundaries) <br /> ��(� , . The riprap installation <br /> (County) (Property ID# [PID#]) <br /> will consist of�along the shoreline of ����.�� , ��� ��� in full <br /> (Linear feet) (Lake) (Bay) <br /> accordance with the Minnehaha Creek Watershed District Shoreline Protection Guideline for <br /> riprap placement required for issuance of a Fast Track General Permit. I have contracted with <br /> ��k�. �o�d- Qf��y'C , 60�c�e�- �k �icC,. ,5�3�1 �� ��y�'ysy <br /> (Name of Company) (Street address) (City) (Zip) (Phone) <br /> /�c �-� , to perform the work who is familiar with the technical ' <br /> (Bond Number) <br /> requirements and has fulfilled the bonding requirements of the watershed district(see page , <br /> two), I have read a nderstand the requirements of the MCWD relating to Shoreline Erosion <br /> tection. <br /> , � � u�- �Z�l�Iz�='( 1 <br /> (Signalure of Property Owner) �� (Date) <br /> Subscribed and sworn to before me on t ' � a of �C�U'l��P� , 2p�� . I <br /> ;�.� �=, Thomas C. Niccum <br /> � '�` �= Notary Public j <br /> '����,�` Minnesota <br /> - °��'°��"��My Commisslon Expires January 31,2012 <br /> Approved by: Date <br /> Dislribution: Property Owner _Contractor _Municipality _DNR t e� � � <br /> Page 1 of 2 � tn � <br /> �E� r�0 �Ztl1S <br /> By <br />