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^ # <br />Tr* <br />f <br />§=“35?=-” 8”r■§S"E'“8K”'™ <br />□other (specify)- - - - - - - - - -- - - - - --- - - - - - - - -- - - - - - - - - - - -- <br />^ppUM^on and infomation .ith the Co^Usioncr of Natural Resources is pr.nm facie <br />evidence of the correctness thereof. <br />COPIES OF THIS APPLICATION AND SUPPORTING <br />DATA HERE SUBltlTTED ON <br />r -r ------------- <br />------------(1^ f.ity. town or Doro»|> <br />(*t-^f < // /</• a' / <br />Address / * <br />---------------Nine of wsiersbed d.siiici j <br />Tiov 'll! OL*f^7/hf7^ A1/a ^'U. <br />Address <br />__________ ____19Zi-Dated this “P day of— <br />Applicant ^ <br />Signed ah '■ ' <br />— >>? 4^ < /</A ^ <_ <br />// 'City Ar £»d /.«-/ _________Phone__iiL=^' <br />State.• / /V ^ 7 Zip.srs“z^ <br />AFFIDAVIT <br />State of llinnesota <br />County of WRNHEPIN <br />08. <br />On thi8__Ztli,day of! ebruarj A.D. 10 7? before me personally appeared <br />> *•»