Temporary Structure/Buoy Permit 3-31-09
CARVER COUNTY SHERIFF'S OFFICE
WATER PATROL UNIT
TEMPORARY STRt.lC'fUREI BUOYPERi'VIIT
Date Issued: March 31, 2009
Permit #: 2009-03
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Cityffwp: Chanhassen
County of:
Carver
Name: Lotus Lake Estates Homeo~ners Association
C/O Lois Anderson, President
P.O. Box 63
Chanhassen, MN 55317
Phone No. h-952 906 9570
You are hereby'. gI"anted a permitt~:.Place afloa~0~raft' swim are~ aridthree(3} mooring
bl.loyS offQ[Qtn~rJ 21 l!U~Ll 2l <?J1Q9ta!VCir~I~Qu~~JJo~,1l'lain,tfiil)~d il)~
accordance with all state and local laws.
Lake: Lotus
From: May 01, 2009
Carver C~;SheriffBud Olson
By Ri:t:: __
Sergeant rek Lee Badge 811
To; November 1,2009
I, the undersigned, agree to observe an laws and regulations relating to the use of
waterways. I understand that this permit does riot relieve me in anyway from any
responsibility of liability I may incur in connection with any activities undertaken
pursuant to this permit. I agree to hold free and harmless the County of Carver and the
Carver G9,Wlty Sheriff's Office as weU,~ its employees and ageIltsfl"9m any and all
actions, claims, liabilities or assertions ofliability which in any m~er arise or may be
alleged to arise from any and all activities connected directly or proximately with the
placement of structures and/or buoys upon public waters.
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Signed: /"{/"&--v; /7 I /;tx:.vU Y y' "-
Permittee
Date: tj It fr/ tJ9
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Printed Name: l OfS /-lnt0'/fSrJr'\.' IfL,f1it:It,~'A? L/..-f;i::; H A-
(Note: The permit is not valid until signed by the perIl1ittee.)