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CITY of ORONO <br /> Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices <br /> • <br /> • - • • On the North Shore of Lake Minnetonka <br /> C <br /> Date�� <br /> , � ' <br /> Owner �C�C�.'C�C,��.- �• s �.:����pE� Phone y�/°� / �l y . <br /> Address - <br /> �`7� -��'�-�' <br /> �,�C.�-c ..��,�, C,,�j� <br /> . <br /> �S� �� l�'� ��'�• ��,20'--// �,.,.�.�-- l� �GGZS� <br /> r <br /> Description of property: � <br /> a���,�/ �,��� <br /> Plat: Parcel: Block: �_____�i��" DU / <br /> Section: Township ��� �, Range : <br /> We , the legal owners of the above described property, will not <br /> hold the City of Orono or the Mound Fire Department liable for <br /> any damage to our property, buildings, trees, bushes, shrubs, etc. , <br /> or any damage that may result from the burning of the above described <br /> structure or structures and hereby agree to clean up the remaining <br /> n <br /> debris. � <br /> ,� <br /> � - � � <br /> Owner or Agent .�,��.� y <br /> � � <br /> j For <br /> Witness: <br /> /' �� 'C <br /> � , <br /> � <br /> BUILDING&ZONING—473-7357 • ADMINISTRATION 8c FINANCE—473-7358 • PUBLIC WORKS=473-7359 <br /> ASSESSING <br />