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<br /> , �11�',0� okON4 � 6122494616 04/z2/99 13:48 � :Q4/0� No:837
<br /> C����t'�'IA�. C�}�tTIFXCA'1`Y[)ly APPLICA�'X'ION
<br /> Ci'1`Y O�' UltONO
<br /> 2'�90 K�IIy P��rkway, P.O. Bo�c �b
<br /> Cr��ta1.Hay, N1N 553�3
<br /> Fhot�ee Zd�-�Op
<br /> su�'rness�- � p��,�.
<br /> �::: ��_�L�_o��.�.
<br /> �lddre�s� � TN � t�:�xss�,e xomc)
<br /> ---��_�.�1__...,_..,_. _.Ft�.L.`._-�...�._.� _..--,� ,�-- ._...
<br /> e�cy:�L����..�.� �,., sc�t�:. �,r� � �
<br /> ����'��...�.
<br /> '�`y�e pf Li�ertsa NCI�; Master Pl�mber ��c�uS� MoVer_ .. pt���
<br /> Stat� �,icense Na. Fs�cpirarlanDnte�
<br /> diava you cvcr had a [icense revuked?,�,�Q 1�yheri �_� �T}�. n � �T
<br /> N4TE; The City dces npt hav� a �peci�+l bcsrjd fnin� to usr. P�r<bf pF V4'orkerB Campens�tion
<br /> insurt�ncp covCrag� i� requirecf for a!1 contractors.
<br /> Check l�ind af trade ap�lyl� fpr:
<br /> ��, 5ept�t �Q.htraCtAr (Requireci; �MPCA Individual .5ewag� Treatrnenc
<br /> Systems �.icen.r.e)
<br /> „�,�„�^,,.�.._ �iouse Mover (Roquircd: $2,O�Q0 Bond, Ip-3U-104,040 Insurance)
<br /> � MeChat�tral (�t.�quircd: $�,OOQ Hur�d� 1U�50-IOQ,00(1 .f.ns��rance)
<br /> ._..�_..�.
<br /> �_ kit�r��►er (£�e-yuir�B: $2,000 8omf, f 0-SA�100.00Q XnSUrance (]R
<br /> a capy vf tlte State Plumbing in�su��n�e/Bonc�}
<br /> Municip�l connections (sewer/wat�r) Yes Nu
<br /> � �_ T.._.,.. Flre $pr1�#cl�r �hstall�r8 (�equincd: $2,00C) Bp�d,. ,10-•5Q-1Q0�000}
<br /> 7UVork shail not cot�rnencc unt;� shas ap�licati��n has be�n appruved and �CCquirrd pemuts are
<br /> issued. Pl�ase imiicate any other perspns auth�rized by yc�u �o apply for permits:
<br /> Tho ut�de�raigped hcreby makts application to the Cit� of Qrar►o, Miru�sota, for crcdendal
<br /> csrctt�car.ion aa indicAc,�d aUrsve, Sub,�c*�;t to [h� l�us of the S�ate of Mlnne.saca �nci tho �rdinaiices
<br /> , �f cha Ciey of qrot�p, Al! appJicat'sons are subj�ct to a te�x {10} day appror�al perio�l, If
<br /> disapproved, writtcn noticc w�IX h� sent.
<br /> Sigt,atur�: � U��:
<br />
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