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1983_0411_packet
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1983_0411_packet
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12/21/2011 1:43:31 PM
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q <br />.0 J'� , <br />RAMSEY COUNTY SHERIFF'S DEPARTMENT SHERIFF CHARLES ZACHARIAS <br />41 <br />�PIER,MIT TO CO3!,,@UCT wATER EXHIBITIONS OR, PLACEMENT OAF STRUCTURES IN THE LAKES' <br />Appl�ica,nt, agrees to defend, hold harmless and pay on behalf of the County of Ramsey* <br />0 &1 cl ai ms <br />Municipalities, Conservation District their officials and emplioyees any demands, <br />ing out of ac4u-,ions of applicant under, the per <br />or, suits aris' <br />0 a I I a 0 9 1 1 1 <br />of I # if of sell <br />■ <br />IL Ito <br />16 2 105� IMP <br />LIM <br />3153 Sandy Hoolk Dr Ro,sielvil,le , 14n 55113 <br />ADDRESS OF PERSON MAKING APPLICATION <br />Lake Nasso <br />STRUCTURE PLACED <br />AKE',- ON WHICH ro <br />F P <br />NT OR EXHIBIT101fio <br />ATTACH DIAGRAM O LAKE WITH LOCATION EQUI, <br />Aw <br />41 <br />SIGNATURE OF APPLICANT <br />RAMSEY COUNTY SHE,RIFF"S W�ATER, PATROL AUTHOIR,IZE,D SIGNATURE DATA <br />.......&PERMIT ISSUED AND APPROVED BY THE RAMSEY COUNTY SHERIFF'S 0EPARTMENTqjqpdjlw4jvw* <br />DA,T E- I P'ERM,IT NUMBER, <br />
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