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<br />RICE CREEK WATERSHED DISTRICT <br />SUITE 177, ARDEN PLAZA I 00 <br />3585 NORTH LEXINGTON AVENUE If) ~ <br />ARDEN HILLS, MINNESOTA 551l2? <br />e e: ~ 0; )Wff ~/t, fb-0 .",-- <br />[.b.~vtJ~ <br />~ ,C!.JV:P;' ~ <br /> <br />(Do not fill <br />PERMIT APPLICATION il <br />Received_--9rI~~g~ <br />Notice Sent 1-;s-Bo <br />Agencla___ ---2.-;;z;;: g- <br />Inspee tCCf <br /> <br />j:n:) <br />c.c:;C~ &i1 I <br />.j jJ;2aJ <br /> <br /> <br />PERMIT APPLICATION <br /> <br />OStormvJa.ter Management Plan <br /> <br />()Final Site Drainage Plan <br /> <br />()Flood Plain Development <br /> <br />()Use and/or Appropriation <br />of Public Waters <br /> <br />OBridge or Culvert Construction <br /> <br />()Wetland Alteration <br /> <br />()Riparian Improvement-Shoreline <br />Setback <br /> <br />()Private Drainage System <br /> <br />0.0ther (explain in Remarks) <br /> <br />Name of Project: fIor/<o<:J;'?'1 A--C} Sho,/-? 8(//c..,o~~<; <br /> <br />Purpose of Project: 70 E~~~/V,~ ~- J.~-r~O().rn /'ig ~ ~(.(.l ~...f-rc. <br /> <br />Location of Proj ect--Address": /9/1/. OJ 1(../ .tt-.p <br /> <br />Municipality or Township: /1//>0/ 6rf(JI~d)'-, /1J/;v~ SJ/I~ <br /> <br />~ of Section Township Range <br /> <br />, Call 4,83-0634 if assis tance in completing this form is required. Please <br />attach drawings, plaris and other data as outlined in "Rice Creek Watershed <br />District Rules and Regulations". Hail or deliver this form along 'tvith a <br />$10.00 administrative fee and ap~ropriate exhibits to the address above. <br /> <br />'fA field inspection fee on this permit shall be charged to cover actual costs <br />related to a field inspection including the investigation of the area affected <br />by the proposed activity, analysis of the proposed activity, services of a <br />consultant and in addition, a fee will be charged for any required subsequent <br />monitoring of the proposed activity.1I M.S.A. 112.88, Sabd. 2. Applying for <br />this permit to RGHD does not preclude your applying for any necessary permiU~ <br />that may be required fromotheE governmental agencies. <br /> <br />To be cOffiuleted by the applic~nt <br />Owner~ (/jO/l<JP# Iffi.lv~E~I'I'\_~ C. <br />Addres~; 19 tv. u.J /Lf'Ct- ~ . <br />City: /lI~&~{Cjhr<t^; ~ S-S-IIJ- <br />.., Zip Code) <br /> <br />Permi t App lic~_t~_on For Approval of <br /> <br />()Land Development -Plans <br /> <br />OGrading, Sediment-Erosion Control <br />Plan <br /> <br />A8-78 <br /> <br />RECEIVED SEP 111980, <br /> <br /> <br />-- GJ5 r-/l- <br />re of Owner <br /> <br /> <br />Remarks <br /> <br />tv h /JA!rJ5 _A-,~- TO ...8'd/t:'/.J <br /> <br />A-,J Ex: r .l5/vJ/ 'o...) CJ E- f- u JA! . <br />Exo'-r;-.; h~rr f)~.A/": ~-:*Tk~ <br />~~t'y1 ~/~r- A/cJ~ jOEf' .oOt.,.,h:v <br />/J-j vTT./?/f'. CAlk: oJ/~ c.."K re^--CJ " <br />tI (/ rT /-=i/C ./r ,,/2 <J S s A/IE '^"" g </lc."o/g <br />A/"".<:? Udr-V"J ,/ ~ j:7 f') r jf:'V ,Ew <br />~ <br /> <br />'" .6Jf~~)r:5 '~OF /fa.EA- 8~J <br />J'J12vJ JJJ/";;/,:] -.-lRl ~o ,Sj Fr <br />