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<br />RICE CREE~ WATERSHED DISTRICT
<br />SUITE 177, ARDEN PLAZA
<br />3585 NORTH LEXINGTON AVENUE
<br />ARDEN HILLS, MINNESOTA 55112
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<br />,...;ga/t..~WiJ.: , PERMIT
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<br />For 0 1ce Use Only ~
<br />PERMIT APPLICATION NO. r~ -/k~
<br />Rec · d Of fice SEP 2 9 199Z Rec 1 d Engr.
<br />Notice Sent q -.;L '1 - K' ;)-
<br />Agenda /0 -;;J ,.,.. /J' ~
<br />Administrati ve Fee $/0 /t.../.,{' II 9 -",)...,~ 3 ;./
<br />Ins ted:
<br />
<br />APPLICATION
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<br />'l'Obe.complet.ed by the applicant.,
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<br />:~~f.B~~i(JJ!t~0(~j~?"":\ Datj' ... Cf:.-~H - 8'',;L
<br />.,..1\~dr~s.~td56i.tZ(E'ulfi.A)yn /tgif;, se-''rel~Phone No. :>~ ~5-1-'3l>1
<br />. Citit':LV.ctuP,ffIGk-rC/Y(~: c~~eV::t (Si~~ ~~~~tized
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<br />(.;- ,-,;.,.;{ .,
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<br />Agent) ,
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<br />of: Remarks:
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<br />"- ',' ',' ,'.., ,-",'" '- -.--';'.
<br />..'t:rcbmprehens:1:'l$.,. .Stormwater
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<br />~;~g~1~gtsa~:it::i:.....
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<br />,< of'Publ.iciwaters ' , '
<br />Brid9~a.ndl or," culvert Construction
<br />" Wetland Al.teration .
<br />'.S1iorelandI(Riparianl Improvement
<br />Pr,ivateDrainage, ,System
<br />Indiyidual Sewage Treatment System
<br />.OtllE!r;- .,,(explain' in remarks )
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<br />+AD();r/lJIV'% E~)51/("C
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<br />'~.../llJ lJDi/VC A{ 4"~j /~f ~.
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<br />I'A 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
<br />affected by the proposed activity, analysis of the proposed activity,
<br />services of a consultant and in addition, a fee will be charged for any
<br />required subsequent monitoring of the proposed activity. I' M.S.A. 112.88,<
<br />Subd. 2. Applying for this permit to RCWD does not preclude your applying
<br />for any necessary permits that may be required from other governmental -.;.,...
<br />agencies. .
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<br />A8-78
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<br />Revised 2/2/81
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