PERMIT `�
<br /> Ci'T� .�F ORONO PERMIT TYPE: - - -
<br /> 2750 Kelley Parkway - P.O. Box 66 Permit Number: �'°-_��%�";'�'``
<br /> Crystal Bay, Minnesota 55323 Date Issued:
<br /> (612) 249-4600 _ - -
<br /> SITE ADDRESS:
<br /> _ ... _ _ _ _ �
<br /> ::,_:._ �_ ; z ; ; ,_ : •,:;,- :i>_;
<br /> ::�
<br /> " ("`_ i _ i 1�, - �"i
<br /> DESCRIPTION:
<br /> ..... .._.. ..._ _. ._._.,
<br /> i_�{�t� � ._�.E��7 j='.�:i'�•;;T, `�r:� -`-`i-- 4-'=.!'I�'.._`,:_..�;�,�rv,.T;
<br /> _._ _ _ . .. _ . , .. ��=:'-,�;M �r::�''-
<br /> t-;° t :`:: �i�_; �"Er•�: ��°.•'C.:�:' r�.. .���.r
<br /> ' _i1_. {_`:._ _,,�+}°.�a.!'; �j'—•,`�
<br /> _'s s"�•;'t.1't_:i_'S.�a�:t-; �' _
<br /> ..__.=:tii°ti _.. ,"!'t
<br /> `.i--' A.I_i'^;. ' i-; _' r-iF:'1 i F i r-,}...i
<br /> . .. . ... �. _. ..»_ _ .. _ _ . . . i . ».._.. . . _.. .
<br /> REMARKS:
<br /> - - r.... � - -- - _-
<br /> -��„i . .� ..�-v ' . . e ! ._'._. � .� _. � � F�s_sl 4 i_. .- 42`��. �. �.. . t .
<br /> _. _ . .. __.__ . . . . . . . . _ _. _ .. . ..... . . . .. . . . .._ .
<br /> : 'i • . �' � . i _
<br /> � � � ' s 1 }-!. � ..� I.
<br /> ..
<br /> . �_... �..,:- , .'..,. . �� i . : r . .. .._. _ . . _ . . .. . ,.
<br /> :.
<br /> ,F. � �.
<br /> FEE SUMMARY:
<br /> . � � , . _ _ _ , ..
<br /> .�_........ . �.._ ss+,+'f� .._._ . �_
<br /> I-'i, ;i"'f . ..�t`}.•�'S�4 d:!:� --- - -
<br /> .J �_. . _ . ... _
<br /> _:€s?'i_�';:�+1��; �_;.'- , ;.i
<br /> -- •- cci - -� i_�-
<br /> _���_• .. k:,ts_i
<br /> _�f�i,: fl};;, �._ .!.
<br /> 3 ri�.ri ! �"_F?F? ...��.�..._���1` y_ ' _—
<br /> CONTRA�TOR .^ _ ' '
<br /> �..: F , �� , .
<br /> . ,,.. , ; , ;
<br /> ..
<br /> OWNER
<br /> :.. .. .. . . .... � . ,,:1 . ,
<br /> : ._ _�::_ =f��. .:;�:=�'r _. , �- —— -. .. _ _ .. _. _ . _ ..._ .:. _ '.. ._. . . ��:"a?'�;�::�:=�'�` ._.. .
<br /> _"i.( '-. 1 t_I:;:-`�•.!'� . .. . _ t:.- . . ., .._. . _�;{f'•..�,j ;r�F:vF __ _ ::1.�
<br /> . '�!�..._ �'�-�„ >>3 ' -
<br /> �ii� t„f��SF�??�"r�3S�1�L�..ij . .�.{•..._L f� 1L.�.Y,ir:�+..+�+Mx� w.,. .. .3 . , � .. f� �F _.� . . ... .. . . ..._ r� ._.. .»j .. � a ..,..f _ "tl" . .
<br /> �:r�'E�'�I r �:.__, :'�C�i� #��a�`',���:; �'�� �};�� �� ��.���.,►�'., t� -a;z t is '_'._ _ .� ._ ._ .. _. . . ��.___ � ._ . . �_
<br /> _ , � -
<br /> �;. . � , ��,� ��.
<br /> ,�
<br /> _ . ... . _. _ . _ _ _ . . . _. �c �*�����g::,�i�t[���:����,,,�!� _ _tl.,�� =�� .� . __. .
<br /> L � �.4
<br /> �
<br /> APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
<br />
|