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Lowe r <br />Rum ��'Ve[ <br />r(mVVM0 <br />START OF EST. COMPLETION APPROVAL <br />PROJECT: DATE: DATE: August 15, 2024 <br />l3v signing this Permit Application, the undersigned consents and agrees onbehalf of the Applicant that: <br />1. The permit application fee bnon-refundable. Escrow deposits will beheld bythe LRRVVMOuntil the project <br />has been completed and all conditions ofissuance nfthe permit are satisfied. The Applicant bresponsible for <br />all expenses incurred bythe LRRVV[wD/nthe processing, adm|n|strat]onondenfooementofthepennit <br />application and permit, The escrow deposit will be used to reimburse the LRRWMO for all expenses incurred <br />bythe LRRVVrNO|nprocessing, administering and enforcing the permit application and permit, including <br />engineering, legal and other consultant costs. |fsuch expenses exceed the escrow deposit, the LRRVVKAOwill <br />bill the Applicant or Permittee for such excess amount and payment will be due within twenty (20) days of <br />mailing the invoice. Timely payment of such invoices is a condition of all permits and work may be stopped on <br />the project for failure tomake payments when due. <br />2. The undersigned, its agents, principal, assigns and/or representatives (hereinafter "Permittee") shall abide by <br />all the standard conditions and special terms and conditions of the LRRWMO. <br />3. Any work that violates the terms of the permit may result in the LRRWMO or the City in which the work is <br />being done immediately causing the work on the project relating to the permit to cease and desist. All work on <br />the project shall cease until the permit conditions are met and approved by the LRRWMO and/or the City in <br />which the work )sbeing done. <br />4. The Permittee agrees to be bound by the terms of the LRRWMO permit requirements, final permit, standard <br />conditions, and special conditions required by the LRRWMO for approval of the permit. The undersigned has <br />the authority to bind the permit holder, the owner of the property and/or any entity performing work on the <br />property pursuant to the terms of LRRWMO permit, and shall be responsible for complying with terms of the <br />LRRVVN1Operm1t. <br />"I certify that I have thoroughly read and understand the above information." <br />Signature ofproperty owner mdeggrfated <br />Agent (no agent without a letter of authority) <br />Print Signer's name <br />Signature ofapplicant Ifdifferent from Date <br />property owner <br />Print Signer's name <br />/=12,0 <br />App|kat�nAcknowledged hy�:V _ � ��Z(IL <br />Name ofCity Official -~ City nauv <br />SIGNATURE OF LRRWMO CHAIRMAN: ** <br />August l5'2024 <br />"NOTE: Subject toconditions oadesignated /nthe UV%A Notice ofDecision osrecommended bythe Technical <br />Evaluation Panel and Barr Engineering (see attached) <br />PERMIT IS NOT VALID IF PROJECT HAS NOT STARTED WITHIN ONE YEAR FROM DATE OF APPROVAL <br />A8doNer'A n0k8' Ramsey"2015First Avenue °A80ka, MN 55303"N8ww. IrrwmOnml <br />