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SEP-1��-1'�'�7 Ei�;:3� f•1I hJt�IEHHHH �:REEI:: I.,.IHTERSHEli E�1��4�1�_��;�� F'.�=�1:•'�=�1 <br /> 97- p�D�J <br /> 11�X1vNEH.A�;�A CREE� WATE�SHED DYS'TRICT <br /> Gray Freshwater Foundation - Suite 37 Ph; 47I-0590 <br /> 250.� Shadywood Road. Excelsior, Ml�i 55331 Fax: 471-OG82 <br /> SHO�tEL.INE ER�S�ON FR07'�CTTi��T� FAST T'�.C� P�RMIT <br /> I, �..y�� e S1�1u.•.� residi�ig at � ao � 1i,n��s�'ot.� 1��►�� <br /> � ([�roperty C)wner) v (Stsect Addrr3,} <br /> r 4n � < « f{lr�l _ S�3N W . PH: Nq 3�- .S b 8 7 , request approval ta instal! <br /> (CitV) (SW[e,7iP) <br /> riprap shoreline erosion protection on property described as _t 1 S o �j�c�a►t �o a� ��l , located in <br /> [Str�l Address) <br /> � �� _ w��,,, ___ � — J j –,�,� � �I The rip rap installation <br /> {City) (rountY) (PQ�#locateil on la.Y slal�m�tt) <br /> will consist of �o� along the shoreGn� of M i K� , C'.�`f�T�� __, in fiall accardance with <br /> (L,inval l'rct) (Laka) f Ii�y) <br /> the Minnehaha Creek Watershed District Shareline Protaction Guideline for riprap placement require� �'�r <br /> issuance af a Fast TraGk General Permit. 1 have contracted �with <br /> ���E�A�!� _. � <br /> (Name oi'Cc���p� MN $5364 (A�iciress) (Phime> <br /> �r+ � , to perforrn the work wl�o is familiar with the technical rec�uirements and has <br /> (lio�id Nwi,�t�j <br /> fulfiIled the bonding requirements of the watersfied district (see reverse) . I have read and understand the <br /> require ents c�f the MCW.D reiatin ta Shureline Erosi��n Pratectian. <br /> � � � 9� <br /> (Signalurt al'pro�rEy o�wier) ^ (Dalc.) <br /> NIiNN • �. CT <br /> 5uhscribed and sw�rn t� b��ore �ne on Ehis $��+ day of �, 1�19�A � <br /> ,.,.,.�„�..:.�,_�. r}, 1997 <br /> � �',X n'• �PIY,�4�tL��.'i�"�1�i'i'�.'��..�::�.:Gii 0�"� S{.,1 � ` <br /> :{'��I'����.�'+ Pd�V.RY P�t�LiC.P.S�P{�;�:�T.4 <br /> � � <br /> �� °�i;�L,.���7 h�P�Ni:'�II�COUE� <br /> °;:L hTY ccrtul�fs�!en C:^7[re�1-31,20tl0 � "" "I"''� � � � <br /> Nvta Public '� �� '� , -;.:: �� �, <br /> Approved By: �� �(7 7 <br /> Ja Hafner, District Teciinician {rr�t�� <br /> 1listrihtttion: Pro�x:rty(7wnvr C:o�.ttraclpr Nlu�liciptlli�ti• f)N1Z • Dis�rict 1�i1L/i:ngtinccrs <br /> fasl <br /> Ti iTHL F'.�_�1 <br />