HomeMy WebLinkAboutMCWD permits i
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JUL � y 2010
Permit# (� -
SHORELINE EROStON PROTECT#ON - FAST TRACK PERNfIT
MINNEHAHA CREEK WATERSHED DlSTRICT (MCWD) �
18202 Minnetonka Bivd. '
Deephaven, MN 55391 Ph: 952-471-0590
Fax: 952-471-0682 ;
E, �,rn ��e.�ex-�;��� res ide at 1�n�:-t �c�-�.. O e_k s �s�a-� �'cS� ,
(Property Owner) (Street Address)
�� {��w _ ,_�1� 5^5341 , 6�z) �o�-�GS request approvai to instal{ riprap ;
(City) (�tatel (Zip) (Phone} '
shoreline erosion protection on property descnbed as_ t '�'� ` ��'�t (,�n„n� 17n , , IocaCed in
(Street address}
�It�,n�, ��•••� _ , O`l 11�►a 3 4 r on S 1 . The riprap installafion
�thin the City boundanes) (County) (Property ID# [P1D#j}
will consist of_ n5 along the shoreline of Y'�l�-4ta , �'�.��t ���� in full
(Lineai feet) (�ake) (Bay) ''
accordance with the Mrnnehaha Creek Watershed District Shorelir�e Pratection Guideline for
riprap piacement required for issuance of a Fast Track General Permit. I have contracted with '
rONCEP'r LAr�lU�1NQ , (�
�I}���ny) (Street address) (City) (Zip) (Phone)
MOUNt7;MA[s$�
�. �:�.. , to perform the work who is famiiia�with the technical
(8ond Number)
requirements and has fiulfiAed the bonding r�quirements of the wafiershed district(see page
two). ve rea understand the requirements of the MCWD relating to Shoreline Erosion
Pro _ � a�-----
(Signatur of Proper#y Owner) (Date)
Subscribeci and swom to befiore me on this ry��^ day of .S� , 20►�.
� � `�r:,;,� JAMES HAROLD SMITH
4 NoUry Publfc
otary Public g� Mlnnesota
My Comm,Explres
�`' J�n 31 201 S
Approved by: Date Z� ��
�
Distribution: _Property Owner Contractor _Municipality �DNR _Oishict File
Page 1 of 2
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Permit# I Q _ . AY 2 0 2010
Sandblanket Permit and Sand 3ource Exhibit Form
FAST TRACK PERMIT
MtNNEHAHA CREEK WATERSHEO DtSTRICT(MCWD)
16202 MINNETONKA BLVD. Ph: 952-4i1-OS90
DEEPHAVEN, MN 65391 Fax: 962-471-0682
I, S,m Q�kec��n resideatl�9�-t C��.11 �-� ��"�4'tG-RcR �_ " +'M �i��
(Property Ovmer) 6{,L (Addrass) (City)
�N �S��I�t , (g�__�o� �G(,S request approval to install a sandblanket on property described
(Stete,ZtP) (Phone} �
as_. ► 3'S1 f�m�,�. Q,.�, �� , located in_ C3�r,� ,
(Street edtlress) (VWlhln the City bounderfes) (Counry)
�7-1 tr� ��►�1 aoSl on �'Y� �k,� , ��� i.�Lkti . '�
(Property ID�k[PIDAj) (Lake) (Bay) i
I have contracted witfCONCEP'i'i.p+NDs�'�N'� '
315 , �� ) (Streetaddceas) II
����,�'� � tc ir�staii clean sand frorn the i
(City,State,2ip) (Phone)
following source 'f�1,..�2.� ��.�, , L��,���
(Supplie� (Address) (C�tY.2iP)
�-���/ 4�8—+-I l�`.�
(Phone} ;
I II insxaN�the sandblanket from the followiflg�source____ ,�-- �
� ' ! ..
t r' , :.�-'' '�1 .�=''`(s��ue�>
,' � �`-",. �
�A��� " (Cfty,5tate,21p) � (Phone)
My shoreline is�_feet and the dimensicns of the proposed sandblanket are: :��1 � X
+ (Length)
� X t o . Sandbianket dimensions cannot exceed a iength of 50'(or 50%of shoreline),
e�� �0 t�df�i1"'
a width of 10' and a depth of 6". If this project requires municipai 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 t fail to submit the required exhibits, the
application is incomplete and will be returned. It will not be reviewed by MCWD staff until complete. 8y
signing this application, � 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 fleld Inspection of the project per MCWD Rule J, provided with this application. I understand the I
District v�ili charge fees ta cover the actual costs of field inspections, including investigation of the area I,
affected by wo ; a�alysis of the work, including the services of legal counsel and engineers, and any I
subsequ t ' ring of�he work. The ' ' t's actual costs a�e deemed to begin accruing when the District �
issu ti��o the viola'ron to pennitt e. I h ve read and understand the WD T chnical Guidelines for
sa dblan ts �—
_ -- - �s l 1 a ;
..~(Signeture ProPertY��) ( ete) I
kt� ' d�and sworn to fore me on this t"t��` da of , 2p I� , !
� �;; JAMES HAROLD SMITN
� ��' '� Notary Publtc �
Notary Public �° Minnesota
� .� My Comm.Explres
`��"`� J�n 31 2015 i
Approved by: Date 5 � l�' li
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