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City of Gem Lake Received <br />Heritage Hall <br />4200.Otter Lake.Road j Gem Lake. MN 55110 AUG 10 2023 <br />651-747-279.0192 ! 651 747-2795 (fax) <br />C E-rrtail City'{CT;�ei 7lai 0111E?.Clrr <br />City of Gem Lake <br />Permit to Allow Archery Deer Hunting. in the City of Gem Lake <br />PERNTIT APPLICATION CHECKLIST: <br />To prevent delay, please. ensure .tlte following information is suhmitted <br />❑ Application Fee (if payingwith cash We can only accept exact change) <br />❑ S I a0.00 <br />❑ .$500.00 Security Deposit (separate check from fee) <br />❑ 5 Plus acre Parcel Verifcd <br />❑ 13ow blunter Education Certificate <br />❑ DNR Permits <br />❑ Deer Starid LocatioiislParcel/Building Lootion/Shooting Lades <br />...-._,.- .._:,......_._...._..._................... ....... ...... ........ .... .......... ............. ............... ........ .1.-,.f.......:.....:.:........................... .-.-.-............. ....... .... <br />.-.. ,._-.................•.. <br />Perrriission is hereby -given to +�i:j'Tlti7!`]� SCv�t JA:i1.A,GC0 lJ .LjCHkcZ Ar' 1 e owner ortheproperly <br />located at �.� iEL� FL�n^ � Geiia Lake, Minnesota, to allow archery deerhuntiiig on the property. <br />The following guidelines must b:e.followed-or you will be in violation of: Ordinance No. I.24B: <br />The permit to allow archery deer hunting on your property shall run during these three weeks and.these.three days of•the week: <br />Month Week Start Week End Year Day of week t)ay of week ,9I ay of week <br />to_1�_ ?4 3 on �AT UIZDA-r- tGi\7c7 �' <br />0 e Etz `-7 to .aej 20 ;D3 5L�Iui>A-Y- <br />!l e'Z 3 .to. ;j 20 .�2,a on, <br />• A copy of this Permit must.be displayed on the premises; and <br />■ Additional requirements of the Gem lake City Council are listed on the reverse side of this permit.. <br />Datc. Mayor, F y of Gem Lake <br />Ilwe, t have. read and understand the abovc:requirentents. <br />G <br />L]a[.e `la p � y vile Signature { Il � ners titust s"v _. <br />Office Use Only <br />1, 5 Plus Acre Parce..I Verified <br />j $140A0 Fee Paid <br />$540M .Security.Deposit <br />Bow Hunters Education. Certificate Verified <br />I�DNR.0ertnits Verified <br />Deer stand 1 ca ti n 1 <br />butldtngs locatio <br />a t v s:� parcel n/shooting lanes. <br />Property <br />❑ City Council Approved <br />hate <br />❑ Deer Harvest Report Received <br />Date:. <br />El Security Deposit Returned <br />Date: <br />ArcheTy Deer. Hun6hg Permit Page i <br />