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�ERMI�' <br /> �k � '� ��` ����°�� ` `- ' " PERMIT TYPE: <br /> c,s_�i�:C!I i��it� <br /> 1335 Brown Rd. South • P.O. Box 66 Permit Number: '_"_��i�}�.�� <br /> Crystai Bay, Minnesota 55323 Date Issued: i��%��1 %:��. <br /> (612) 473-7357 <br /> SITE ADDRESS: <br /> i;z�t i Eta►H;:�'_; �'i �;� <br /> .j� <br /> (" . .l . �4 . . �_3`�"_.L � (""�' _ _—i;!i_3i` <br /> DESCRIPTION: <br /> i.?��s.z Fi�.`.�i�?i.�i+l��c <br /> C*U11L71ti',� �°C1'ffil�• i '{='r= ?„}�!`#i3l��i';i�'i�_•.iP`H! <br /> r: rh:r. r�^.a <br /> i�l.al �.���li!'=,1 31�.���1'�-. ! i'C�M� i_l�tj%I—r��1FV1..•�("HL. <br />� . "R"�z � �`T° � - � , <br /> te > 2 <br /> � � <br /> . <br /> 3 z .�'M1 � .._� � � , , . . . ; .. <br /> 'H <br /> � � _ �r � � ��� � <br />: �.. ��' �a�. �� ��i� r � 7af � <br /> _. _ __ _ __— —-- - _ _ _ <br /> REMARKS: J�ouNDATzoNs & ALL DEMO DEBRIS TO BE REMOVED FROM GROUND AND <br /> DISPOSED OF OFF SITE PER PCA REGULATT�NS. WELLS MUST BE ABANDONED. <br /> INSPECTION BEFORE BACKFILLING. <br /> — — -- .___ ._�_____..--------___.____._---__._ - ----_ _ __ .__ _ __ _____-- -_. ._-- _------ _. _ <br /> FEE SUIIAMARY: <br /> �.�t-ii i jj-'i f T f_t�.! x.t .��,_;'•J <br /> �.��.�� �w't+ �S�:i ,i:;?:i <br /> x. ' s-',f} <br /> i•7�s i% i'iC i rf�r' fi <br /> ���t.j 1'l S i;�{}-��C ---._.��_- --�.�;y uS 1 e v� vt�ve u <br /> _a i J r - C'e i�+ t�C il�CTi•C <br /> ^�•;y+_; .(� ! 1 t�f7l�4L L'! ! 1 t+L <br /> i�i�.d i �t`C ' - i ii— fil3ii � <br /> lr•l,��vvv�� n <br /> �t 4 !� rf! f�eri <br /> 1 �I:Li� ✓V�VV <br /> li.Li.LlffuVV•V � <br /> j'� �L�1 LTLft aYv <br /> y,�tjt�.�•j� �L7 JV i�V <br /> t�LL•Ldl T-7 1�/'n1 tlt !��47 <br /> +3'%c� r i•rfii7 f�i�d r{t�rt <br /> T►a�Lil�-'1�L 4VV1 �jVt !1J•J1. <br /> '!i!j!4 !{��j <br /> • 1L�tt1t fJ <br /> CONTRACTOR: -- ��..��i i c�;;t. -- OWNER: , <br /> r- . .- ._. ,_..'� _t a • - ',` ` -'' r�:i,�-1' r-�_,r, nl-it_�`�-{ <br /> �� r �,. 4..1_ij°�'.�: i���(. � t_i�y i_:�„_���3'=7ii_� _ ��_�._� <br /> �,;:;'1-.�i I�i i 1-i�31",{-ri �1 i ;;�i;_::� �`��HL7i1i� L_�-� <br /> �;-"y'j'!i_{s_� !!"3! ifF�4 ���4�r! �i'.'i���� � � {'i{ii :ti`}.�.'a}-� <br /> ��1...�}'}_ _ f f'4 <br /> i.�_,1'..:..} ."�--!_!`3l t.,: �.'�`•�'—�-:'!_)i i <br /> _._._...._... ------ ----------�-- ---'--_._ . <br /> ...._.._._.._-------'—.---._._._�.�_"-.____---__._.r. _-_.._____ . <br /> ._. . _-----�--__e.._. ...__...._--- <br /> _� <br /> ' ! :�-. � :F�:... •. -,� •r-�.-r�. r:r r:r..�- �r;;�:r _.a;�- -:!-n; •-,r���t ' � <br /> ta� �r-�� �_i}yi.?€-.f'1�����,73�f?_i1 F"!t_t�r s.:�p' �'1=-i`!`f�-._� E ._ r r_�-�} M i.:, ��j,i_.,.�}•,{ �%E ��i�P••.m". f !'":�= E+i_Y'4i._ ll�i-F�s_;4€:!`!€_��'�f�t�. <br /> "•F'":{_:�� f— i. :°}'', -•�T1� <br /> ,, _ ._ . <br /> �'. t r _ -. t • y: tl _�; " ;.•� ' `... � '- <br /> :=c-�_E:Z lf �, r'�F t� z—it.�t � �_ i:,�_. ���--.... }� r-. �i� _� i;�°'i?..i _�_. �E _�(-�s�1�_��_ �! �� H' �s � � —�;� <br /> �;. r;s"�:�t.._ L ....- .-- � �. _ Y ___r.. . �! � . . ` ,-• -'` .�r_ ., .•. �;� . . <br /> e � i i ' i <br /> ,,.: . : . � r,� -r r. h=. r <br /> � ht r "�.-� r <br /> � .r;t_i�•.��_} t is?E1 J.tyH!'�{l•C:.•_ !-�9i'•il _> !r-� i r� :_��- j�) i.!��i��C:.::���y S t"f ['�'•_t 3�_L.?r.Sy4"! �•i_1LJC_ T?���:,`=�1!'t�..l'i��'�1�_ <br /> L LL <br /> � � �j�,���'t/� <br /> APP�IC T�PERMITEE SIGNATURE ISSUED BY:SIGNATURE �Q��� <br />