|
� , � PERMIT
<br /> �'IT� �� ����� PERMIT TYPE:
<br /> 27�0 Kelley Parkway- P.O. Box 66 -
<br /> �� ..,
<br /> Crystal Bay, Minnesota 55323 Permit Number: , ; �,_. . .,
<br /> (612) 473-7357 Date Issued: i`:;�: : :`_: : :�::��
<br /> SITE ADDRESS:
<br /> �:�i ;v;_,,;°-�-� �,;��,-_;;..� .�. .
<br /> DESCRIPTION:
<br /> j. t•��. .. ..'`.:�...
<br /> . ... ._-:i1if_i.i _ "'}..�'t"�'i��. , .f.,: '" i�1 i��_{Lj��_
<br /> ' i.l:�.:-.'. e. 1}_.,k� �_7. . . � ._.
<br /> ����.ffji!�.i_ ! �.. .. ..� . .. S �r i.�F�.a F�;�,:�j� . i ;e_��'3 �,
<br /> .L i�E����;y' :��1lt=�("r.j:��� �
<br /> REMARKS:
<br /> FEE SUMMARY:
<br /> -�''i- -''�-`:�t ;:���. . ��i�-:-
<br /> 5��.=..__.. . �•� . ��.:, . : _ �•ir':��L ���� ___...____.. _��..1_-���'
<br /> _;_�41'�%"'i;-��•:�;�, ��____.._.__ `�j.�",ta) ��vt�,.�a;� E—w�•�, ����,' , •':i;:l
<br /> _�f�i Y.i��'..�y . �� . � .
<br /> CONTRACTOR: �� . - = � =� - - ` OWNER:
<br /> _ _ .. � .. _
<br /> : , , , , ,
<br /> ; ; ; ,;
<br /> :-._y ..--.: � . . � . , " '' 'a.��� '. :, " . �.
<br /> ... _ ` ". . . ...�_.._. . . . _. _ . _ _ . . ��. . 1'. , .. .. � . .
<br /> . _. .. .,.... .���. .._1-W . .. � � . - ... ._ .... .._ . .. . _ _ _ '�.
<br /> ..,.., .._ . �..�. �,. . _ _ ;.
<br /> : �.��y : i:''.'.... ....: ...! �i�;�'�iy'�r� �'�'�...i�.4.._._ . .._ _,��'4^•._ i _. f ..._ ..e,S .... J;..j� T' _ '
<br /> �"�� � � '7 F-� . r_ .. . ;`. .... _ . . f-a: �. .. ,._ . ._ . . ... . .
<br /> -.;- -- , .._ - ,_ .�..... �._ %,9 : _ . _ _ _ . .. . . .___ �:_ . ?`-� . __...� _. ._ ! _,�.
<br /> '�'•�-'i�::.;j"'j. ` j 4 L � ` t _ .. ,V,�.....f.7�;�;.,4:- - _! t� I � F `i�3 - `.3� i� -'��.�
<br /> ; . .; , . ;.-;� . _» , _ __ _ . _ .___ ._. . .___ .. ..__. .,_. . _ .
<br /> .. .._ ._ _ .._. _. .. ._ .,__ . . ._ . . !._ '_ _ " . _
<br /> L . ._ ___. _ �
<br /> �'jYlll�p� ' .�.a�
<br /> APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE
<br />
|