HomeMy WebLinkAboutMill Pond signature form for webMill Pond harvester permit signature form
A signature form is required to permit aquatic plant removal along your shoreline. Harvesting adjacent to your shoreline will not occur unless a signature form is received. Please complete
and return to 7450 Metro Boulevard Edina, MN 55439 in care of Jessica Wilson or email a photo or PDF copy to JWilson@EdinaMN.gov
The size of area proposed to be treated may be found using ‘Mill Pond size of area proposed to be treated.PDF’ in the Water Resources Library. http://edinadocs.edinamn.gov/WebLink/0/fol/322225/Row1.a
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APPLICATION FOR A PERMIT TO CONTROL: AQUATIC PLANTS, ALGAE, SWIMMER’S ITCH, AND LEECHES
(Please Print or Type)
Applicant’s Name (First, MI, Last)
Day Time Phone Number
Cell Phone Number
Lake Home Address (# and street, RFD, Box #, City, State, Zip Code
Lake Residence Phone Number
Permanent Mailing Address (Indicate if it is the same as above)
E-mail Address
SIZE OF AREA PROPOSED TO BE TREATED: My property extends _____ ft along shore. Proposed treatment area extends _____ ft along shore by to center channel ft lakeward, and/or in a
channel _____ feet long and _____ feet in width extending to open water.
By signing this form I hereby make application for a permit to destroy or control aquatic vegetation or aquatic nuisance as described above. I understand that the control of aquatic
nuisances, including destruction of aquatic plants and algae, is subject to rules of the Commissioner of Natural Resources. I understand that an Aquatic Plant Management Specialist
may wish to inspect the proposed treatment area before, during, and/or after work is completed and that by making this application I give permission to the specialist to enter my property
to make such inspection at reasonable times. I understand that an annual report will be required on results achieved.
Completion of this form and processing of the accompanying application fee does not constitute obtaining a permit.
Applicants Signature
Date