HomeMy WebLinkAboutMCWD permit FEB-10-2005 10�56 P.02i02
P�rmit #�
SH�R�L�NE ERaSlal� PROTECTION - FA�T TRACf4 PERMI�'
M�NNEHA�HA CREEK WATERa�HEp pISTR�CT(MCWa)
182A2 MIMNET4hIKA @LVD. Ph: 852-47�-0590
DE�PHAVEN, MN 55�91 Fax: 85�;-471-0682
f, � �`'��� < <r�1 reside at �99 l � er n esS Yo�.ri t �oc�
tProp ny Owner) (91�a ddress)
_�a.i.4�a, . M� _ 553�.1� (qsz ��1-1Jo1 requsst aPProya!ta ir�stall ri{�rap
f��=Yl (State) (Z1P) (Phvne) -
. shoreline erasio� pratectlon on pru�erty d�scribed as W q i F'a.aern�sg P#, Rd . located in
. ( M (st t add►�ass�
. - The fiprap instal�ation
(Wi in Ihe Ciry boundarfes� (County� (Properiy ID M [A�D��)
will consist of_�slong the sf�orelin�of Mi�1h e�n ka. . I,�J-�s-� �r n��in full
{Un�e�faec) (L�kal — - (gay�
a�corda�ce with the MinneMaha Creek Watec�hed Dlstrict Shorelirre Protectlon duideline for
riprsp piaoe�nent required for i�sue�nce of a Fast Track Gen�ra9 Permit I have cv�tracted wRh
i"\iC'�C�i'.l �sCc�TTCC�'�4�.'1 7C1 ril�.v►�G� w`�C"�crJ.r. S.s.S�� �t� ���,jS�c�s'
{Namt oi GomP�Y� iSarseet address) ~ (�rtYI (Z�P1 (Phon�)
�0�1� 3���N 3 ,to ��ertomn#he work who is famiiisr with the technical
(Bond Number) .
requirernents and has fulfifled the b�onding requiremer�ts af the water�hsd dlstrlet(see pa�ge
two). I have r�ad ar�t(understand t�e requirem�nts o�f the MCW a rsl�ting to Shoreline Erasion
Pcotect�on. ..
+ � z/��/�
t8�9n of ProAett�►Uwner) (p�� .
Suhs "be and swom o befiore m�an th is_ i�day of _ � o r , 20Q�.
G), ' . , MATTHEVfI�.�SCHMIDT
Notary�ublle .
Notary I�ublic �' , Mlnnesota
�„i,,,r�ti;, r�s ' r 9i aooe, .
approved by. �ate
Dlstnbuqan: _p�Uper'�y pwnef _Conhactor �MUnlCipbtlity _,phlR Dtsttkt RIB
Page i of 2
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TOTAL P.02