Laserfiche WebLink
Narne, of sits whjtre ac!Mtyl wilI take, pl" <br />21FJT.#YKjW&W <br />4* <br />tj 9 <br />Date(s) of activity <br />City state, 7jp codie <br />W. <br />3 c! v ) LLe, -wo MAj� 4 1 <br />County <br />R f7 + r 11100 kill" <br />dp%M <br />Signature, 41%.04w-i'vinspawfication, <br />a <br />I M7. <br />Signature of person receiving application <br />Tidle <br />VM16-8c -I I <br />PM — Orgardtfown M this application and fee Of $125 ('che�ck m�ade, out to Commissioner of Revenue) tO: <br />V4kw — Bcwd relume lo Orgammum to <br />0MV1415 *$Ndbd� we" Dielpart,m�e�nt of Garning - Garnbling Control Division <br />QV Cw CaRAY Mail Stadion 33151 <br />St., Paul, MINI 51511461-3315 <br />