Loading...
HomeMy WebLinkAboutMCWD permits _ FEE—�c-1'�'=�� 14�4�=; I•l I f lllEHHHH C:F'EEI':: I:,:Ii=�TEF°-�HEI! ��1�4�it=�r_�� F'.t=�1 'G_r� ;.: . . �7— 39 I���NN���A�A C1�EK WATERSHE�] DX�T��CT Gx'�y �'�reshwater �'ou�ndation - Suite 37 Ph: 471-4590 2500 Shadywood Raad, Excelsior, N�N 55331 l��'ax: 471-06SZ SHO�tELINE ER(�SIQN PROTECTYQN'- �'A.S'�' `�'�.A►.CK PERMIT I,�a� �n e��f� r+�siding at ��]�',� �c�-.co �O��a� tr���y o���} �s���Aaa�-�� ��Q , ���. p�; ��/ J -7 7n$ , re�uest approv�.l to ic�stall (c�tY) (State,riP) riprap sl�oreline erpsion protection on prpperty descnbec� as �a.,�..- , located in (Street Address} ��.,� , �.�.,,� �a - }�� �- �3 �.3 -. oo�- The rip rap installation (Gity) (County) {PID# located on taz statcmcnl) w�ill c:.onsist of !v o along the shorelin� of �'1'l�r�c�t , �p .{���� , in ful! accordance tuith (Lineal feet) (La1:e) (Bay} the I��'Iinne�a�ia Creek Watershcd District Shoreline Protection Guideline for ripr�p pi3cement r�quired for issuanc� of a Fasi Traek General Permit. I have contracted with ----�-,y�--w•-�----- ..... � [�CNG'�'`LJ�I�IDSCAF�INQ � ��--, (Ngmc_oCC��'���T ��� (Adclic-ss) . lPlionc) . ;,;�MOUNO� I�IN 6�3�4 � ` �" ' �_to pertarrr� the r�vark who is fan�iliar ���ith the technical rcquirctnents a��d k�a� {Bond NmnU ) fulfil�ed the honding requirements of ttle waters�ied district c see reverse) I have read and uncicrstand the rc�uirement..� . MCW relati�lg to Shorc;lir�e Erusion Yrotection. Iv}INIVEFila{;�+ 1=;���K � - � WATEFfSME[� C}IS'1`RICT � (Signalttrc ol praperty owt�e��) (D�tcl F�� z � � Subscribed and sworn to betore me c�n this ay� day of , 1997_ �-��, ,;: �„ ,� � � � �� �� � �:� � � .o..�..r.�.4....�.....�...�a�g.,..,�..., � . � � ,a�;����^e-�.��.��.,4�E:+sd.�s�'�a . , , ;.. �y�l .++'A�� nrJ{ZjaFi ^�.inR�L�e.C1/�C^,�cd1;��_{y,^-��'ii.4 � _-�� C`ll"��il�r''�4' t-JL�I�iWY'�IIY I�VV�V E i Nat ry Public """� M:•''.�=rf�m;=tilGn tl),7lfea i-�'i-200(1 �w..,.,..�_..,,...... Approvec4 By: �'2�4�� Suza ne VVeedn�an, Assist�nt Directar �Pt�rz� 1)ist�ihuiton' Property f)�vitcr Co11t1�ctoY Municipality L3NR L�istnct FiJe/�ngin�rs fast ., FEE �c� 1'�'�+� 14�4'� 1�1I�l�JEHHHH �=F'EEF' I,IHTEF"=;HEL� 61�471�=��''� F'.�=r� 't=�� SANDSL,A.�II�ET PE�.M�T & S,F�.�1la S�L7RCE E�HrBIT FORM MINNEI�AI-�A CREEK W�TEP�SHED DIS'1'RICT - P�P�MIT 97 � '� � 1,� anrt_ ����n� rcysidin}� nt_ ��1�� _ �i�a c.-a b +f�C �h.c`rw � �S���__ Fit�perty Qwncr Addtrss (;itY,State,Zip '�f��1 - ��og _ _ �.�- , orPTD# � -11"7- �3 �-�-voo-� Plionc County Tu�vnship,Scetipn,R�nge (E�rx�m pmperfy tax�teme»t) 'own attd occupy the above single f�mily residet�,ce and w�sh ta install a s�.ndblanket on Y`i?�-k a - ��� ��k �xr&$�Y ------ . �:--��-. � GO�C�"f�UN06CAP�Nc� [� I have contractec�with r� at �)S�S PR1 Iiccnsed coiifractor ',;._�..` � c�� , to install clean san� frozn the falIowing sour�e: cit_y,sfntc,zip �?hone ��� `�`..�' a�-�-- 'C�-��c� , '`��5/g-�}/7 � ,Or: stipplir.r addr��s ��Il6t1C ❑ t will ie�stfil� �}1�. $t121C�1�li3Yl�C� YCi��1Clf�IOItl E�lG f0110W1Y1�,T SOL1CCe. � sti�5��licr - - > sdcir�s.s phonc If this pr�je�f �-equz��es municipal approval or review, p�ease attach �ocu���erttati4�t1 of t1t� �rtu.r��cipa] approval w�tl� tltis ap�l�cai-ion. My sjlor•eIine is $� feet<�nd thc ditncnsiotls bf t�1c propost.d saildbl��nke_t �ir�.: `'��� (Ixn��;th) x-�_� (wic�th} x �� (�zpth). S1ndblanket diizl�nsiorts cannot e�;ceec� F3 lei���t}i of;0' (or �0'% of s}Zoreliiie), a widt}l af 10�i12lC�I � (IC�.�t�l C�f ���. . I uttidet'stattd th��t il tllis ap}�licatioti is noi co�nplcte;ly filled out, ar if i fail to �L1��IYllt f{1� i��L�L11Y"�L� �Yhik�it,, flie ap��lc�aiion is irlc:ottiplete �r�d �.�riJl l?e r�E�irne:c�. It �uill 11ot }�e �'e.�Jie���ed �iy MC\�'L� staff tiritil complete_ L-�y sigi�in�; tjtis �1��pli��tiorl, I a�,ree ��nd urlae�siand that thc L�ititri�t Itl�i�� enter the proper-ty at i�easanable fli����-s Eo corlduct at� in.Sp�:�Eian to c�eterinirie w�tefh�r t�tc- t�rttt5 of tllc pertnit a.re bein� mct. I turther tirtc���t'yland th.it if I violate t�1� fcrms �t1d conditiorls of a ��ertnit thak ts is9�_t�'d bi�S���l lzpbtt t�lts �ipplicFif1011, t11e �)��tr1Ct S�lall CL�TlL�tdC� Z flC�a IItS�C�'tlOtl Ot flle j71"O��C.L �i�� MC�W� �'UI� J, �7rl�Vll�l'4� Wlt�l t�lly �ij?pI1C=�i�lOtl. I un,dea•stattd thr� L7ist�•ict ��vill cha���e fees E�i covci•#}te actu�l cost5 of .fi.e.ld ittsrt-�:fic}iis, 1Il(:II.iC�121`y 1t1VCStly<�tiost or t�ie area affeckcd by the �uor.�k, i1I1cl��tti��; �]l f�lE: \�IO?'�, 1}IL�UC�IkI��;, f}l� 4�CVLC�S (7f ��:�y'.il l'UlII1SC'� fiL1C� 4Tl�;lIZCC1'ti� ilYlC� 1}1y' �U�S�i�U4=llt ITlO1l1tOT'1}l� OF i}lr W�7T-�i. r�1C �LStk"1Cf�ti 3CtL1R1 COSfS ��Y�� C�C��t'Tll�� �����i}Y�,��l,�}kI'�1����'LC=tl t�ie Dis�rict issiles natic-c of rlte. viola[iott to Eh� permittee. [ �tave read attd uttd��rst�lhA6t�t�����'f�I��h�iT��il G �lin��s�for�•.�� bJan ets. �� � .,�--�, ;, - ��� 2 5 19�7 1 ��� �/�7 Si�klatUt'� of property �± ler C)atc � � tiu��.c�ribcd a��d sworxi to befdre ���e t}lis � d��y of�� 1�)9 7 . � �-� '�.J�" ;�� � �,� =.e � YhI�/.tnn.1++Y�.��•••ww/,.w wt.rrv..�..... � - ,��-ir.� �1E�'.�err'cJ i"J!`�G`C�'LCJ��"JJI�C'J ��u,ii'�I'�h;l ����,i�.�:1'PC'CLlC-t:��:lh�'"�TA ���;::����`;��; r��i�.n3u_����a c��ra�v NOt T �11U11[; ,li��a�n�'� htyca�er+7'ian4xplrc91�7-�Cs44 !--'' ��� �� App�-Qv and Acceple�i by Date ��IZ;�n . We�dtnai�t, Ass1St�lnt Directok' sanclI -Jan�7 TLiTHL F'.�=t�