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<br />Date <br /> <br /> <br />Submittalllequlremena <br />Complete appli<:ations must be submitted 20 aleftd,r days prior to the regular lloard of Managers meeting; gene...lly the foUrth Wednesday of <br />each month (check website for en.a meeting dates). Applicants must submit 3 QJpies of all required infOrmation as specified in our Rules (see <br />website for complew rules or CORtaCt me office (or a printed mpy). projeas involving a Wetland Replacement p/Qn have spedal notidng <br />requirements and require the submittal of 8 copies of aU ",,~rland4related subrrUttaI materials. Due to me noticing requirements. applications <br />involving a. wetland replacement pliJ1 must be .$Ubmitted at I~t 3' ~4ar days prior to the Board Meeting. <br /> <br />Applicant Signature <br />., undermmd that, as the permia:ee, I am legally accountable to ensure compfl3.nce with terms ilnd conditions of the permit. I undem:and thar I <br />NIl not iUchorixed to begin the projea until I ~eive the permit and the permit sign is posted on site. If the projea is modified. J will obtain <br />approval by the Rice Creek Wamtshed Dis1:rict' before I continue with the project. I authortze the Oimfcr. and its agents.. employees. officers and <br />-contm:to~ to enter the project fa perform ~y insp<<rions.or work aumorited by tht: ~[or any applicable law." <br /> <br />-I c;ertify that I have thoroughly rem ilnd uodemand the above information." <br /> <br />~~/~IM~ =- <br /> <br />Signature ofpmnitee ord~ued agenr <br />(no 'gents without a lettvr of authority) <br /> <br />'5- u(-(7 7 <br /> <br />lJoU~d T {! hili 6tB,uSN..J <br />Print signer's name <br /> <br />SUCCessful Bidder <br />"I[ L I <br /> <br />Successful Bidcler Signature <br />". understlnd that. as tthe successful bidder4 I am legally accountable to ensure compliance witl1 tenns and conditions of the permit. I <br />understand that I am not authorized to begin the projec:t uncir I receive the permit and the permit sign is posted on site. If the project is <br />modified" I wiD obtain ilpproval by the Rice Creek Watershed District before. continue with the project. I authorize the Oittrict. and its agentS. <br />em~ officers and conua.crors. co enrer the project: to perman any inspections or work. 3fithorized by the permit Of any applicable law." <br /> <br />'1 cetTify that I hav~ thoroughly rt'ad and undemand the above infom1atlon." <br /> <br />Sign....... of$u=osful bidder or designated agent <br />(no agents without a letter of authority) <br /> <br />Date <br /> <br />Print signets name <br /> <br />Company: <br />Address: <br />Oty; <br /> <br />State:: <br />Phone : <br />F3lC <br />...maj~ <br /> <br />ZlP: <br /> <br />RCWD Permit <br />Application Form <br />Revised: 5/4/2005 <br /> <br />COO 'Q <br /> <br />11l99Lm9 'oN XV:! <br /> <br />:J/lmfifll:lmli\Il <br /> <br />nv lO:Ol nHl LOOl-l!-AVn <br />