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City of Germ Lake Received <br />Hall <br />4200 Otter Lake. Road I Gem Lake, MN 551 10 <br />651-747-2790/921651-747-2795 (fax) AUG 11 2022 <br />E-rnaii city@gcr6lakcmn:ort; <br />City of Gem take <br />Permit to Allow Archery Deer Hunting in the City of Gem Lake <br />PERMIT APPLICATION CHECKLIST: <br />To prevent deIay, please ensure. the fallowing information is submitted <br />❑ Application Fee (if paying with cash we can only accept exact change) <br />O $.100.00 <br />0 $500.-00 5ecuritp Deposit (separate clieck. from Ycc) <br />❑ .5 Plus Acre Parcel Verified <br />❑ Bow Hunter Education Certificate <br />❑ DNR Permits <br />❑ Dcer Stand L:ocat'tons/Pareel/BuiWing Location/Shooting Lanes <br />Pdrmission is hereby given to CC��NJ►�IgCC b. owner of the property <br />located at i L,tpM Gem Lake, Minnesota,:to allow archery deer hunting on.the.property. <br />The following guidelines must be followed or you will be in.violation of Ordinance No. 124B: <br />The emit to allow arc deer huntin on our roe . shall run from t>'� . 2 Y" �r n '" , 20 1 2.7, <br />P ry g Y P P n?' S �O o+r '�D <br />to I LgTo- Vet LD 20 �_ (three week. maximum);. <br />•. Shooting of the bow:and arrow shall. .be on the following three days of each week only: <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 />Date i ,{ <br />I/we,. ALrrHCHJY �0k3k.UACC O /1'"l t c <br />Date <br />Office Use Only <br />d 5 Plus Acre Parcel Verified - <br />Ed 5100.00 Fee. Paid <br />i $500.00 Security Deposit <br />d Bow Hunters Education Certificate: Verified <br />d DNR Permits Verified <br />l� .Deer stand locations/parceVbuildings location/shooting lanes <br />Mayor; City::of Gem.Lake. <br />haveread and understand the above requirements_ <br />u <br />11%4vrff, Oivner Signature <br />❑ City Council Approved <br />Dale. <br />❑ Deer. Harvest Report Received <br />Date.: <br />❑ Security Deposit Returned <br />Date: <br />must sIgn) <br />