2018.05.21 CC packet - Laserfiche WebLink

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(" Washington � Cotlnty Office of the Sheriff Commitment to Excefknce Dan Starry Sheriff Brian R. Mueller Chief Deputy APPLICATION FOR WATER SURFACE USE PERMIT pursuant to MN Rules 6110.1800 To Place a raft, buoy, or other (s�tructu/re on or in the waters of this countyp l� r /f / /( L Home phone: Name: f'Y�F c° -- $ il5 1;92 1-i-VI / V Work Phone: Fax: Address: — Zip Code:_ E-Mail:_ --- Body Body of water where structure will be located: 1ri f � Type of structure:�� ucture'(dates) to Installation of str5 C— Permit requirements: 1. Diagram of water surface showing placement of structure, include the depth of the water at the location of the structure. 2. Permit must be issued before structure is placed on or in the water. 3. Floating rafts, swim buoys and mooring buoys structures must be within 100 feet opermit holder's property lines as they extend into the water. 4. Structure must display proper reflective material as described in MN State Rule 6110.1800. g. Permit number must be displayed tsing numbers that are at least two inches high and a contrasting color to the area where they are attached. 6. Water ski slalom courses and water ski jumps must be approved' annually by the City Council or Township Board where the course will be located, special restrictions may apply. Slalom courses cannot exceed 900 feet in length and must display the permit number on the end floats. Slalom courses and ski jumps cannot be a navigational hazard. Water ski jumps must be lighted during the hours of darkness. City/Township Representative printed name:_ Signature: Date: Signature of Applicant: Law Enforcement Center • 15015 62nd Street North — P.O. Box 3801, Stillwater, Minnesota 55082-3801 Phone: 651-430-7600 - Fax: 651-430-7603 • TTY: 651-430-6246 www.co.washington.mn.us _ ... , nm_...,...+;..., n..+inn