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� .� I'ERMIT <br /> � <br /> � �IT'� �� t7RON0 PERMIT TYPE: ��,_; , �����E� <br /> 1335 Brown Rd. South • P.O. Box 66 PermitNumber: t?(�,�j���j <br /> Crystal Bay, Minnesota 55323 Date Issued: i r��Ii��.1_=�i <br /> (612) 473-7357 <br /> SITE ADDRESS: <br /> i�7t r �TH AVE N <br /> L'=:U <br /> F'. I . N. � '�t�.—i 1��—;�::,—:zL—�:}�:�c��:=: <br /> DESCRIPTION: <br /> F'�S�F�::I h�l��!G�F�Cj I hlt� <br /> l�ser P���tr,i t� TY���- Lt�rt�C! �rLTE��tT i�+N <br /> , � ���� �� � •�� � . <br /> �, � ��, � �� .�.� ����� ��rr oF �.�tr�ro <br /> � , <br /> � � � �x <br /> � �4 = ���'c 5� �z A � 1�� ����� f���v�Nt�� C�FFI�F <br /> ,� �� ��` :� ��'� �� # "� `� �'� �:�1,s;s;��3c� # <br /> ��� � �} ���' � � � �� � �J.f GF� St�.44 <br /> � ��� �.��� ��,����� �"` � �;fff'�ft' T� 54,t�' <br /> �t ��_ 4 � �� >,,�� <br /> �� r �����: ���� �� M�� ,�tti��;�r-r��� �c�u <br /> � � <br /> � -� �� � � ,t �;, ���I3�v L;;L'.# Mt�� T�'�=3� <br /> � ; , � �:_ ��,� � ��, � z . <br /> �� � � � �, L'#:'J�:�t <br /> � � \.� � .�' � <br /> } , <br /> ; �� � � , � <br /> w}y ��� � a4 �, <br /> ` �� � � �� ��� <br /> '," :� _,� sr,.r � <br /> REMARKS: <br /> i�AX T Ml1Nf� 1 i�t i �:t!�:I�: YARD:_; <br /> FEE SUMMARY: <br /> E�as� FCC ^_—_—_—^�.��—,�?ycyir <br /> Tt��#�al Fee ���_�.i��i <br /> CONTRACTOR: OWNER: — A��F�1 i c ant. — <br /> �1H I T�IAN .Ji=iHN <br /> f�7�} F�TH AUE M <br /> 1 I�I_!�1 i �� �Ci:3SF <br /> f t=.�.;�1,Q.7�"i—:]1{��� <br /> ___ ___ _ _----_,______ __. _..__ _ _. ___ _---__ --__----__�___ <br /> _ ____.-- _. __-- ---- __.._ _ -- <br /> T�-!� t ti�1DER:=�I Gi�lED ;�i���E�Y ��;i�fi��=;T'=: h'�r't1 i°���_;i r i{y T�� i'tf�'r�::E THE �:E�L I t i�='�iiiil�:tl�t�l�i��� <br /> '=�F'E�:I F I E�Cr �h�C; ��a!;�E'�� Tt�� �;��i !�:?�._ �':��F:k:: I hi �=;Tf;I C:i �:���t�F'L 1 Ht�C:� �l I#;-( �t�€ t:I►'Y i�►F <br /> � <br /> s���i i�.��R �i�'D I Ni�hI�:E�'; r�l��J '=i7€,TE +�ji� i�1 I�i���'=,s i�i� E!?I L�i I tdj,� �=i�UF �i�s:�i.s'���i•��f•�i'_� . <br /> APPLICANT/PERMITEE SIGNATURE SUED BY:SIGNATURE C� <br />