Laserfiche WebLink
Note: Applicant to complete all lines, except last two, which will be completed by <br /> issuing officer. Enclose $2.00 permit fee in accordance with North Dakota <br /> Century Code 23-15-03 and return to Cass County Auditor, P.O. Box 2806, <br /> Fargo, ND 58108. <br /> RECEIVED <br /> APPLICATION/PERMIT FOR FIREWORKS DISPLAY <br /> FOR ENTERTAINMENT PURPOSES FEB 2 " 2014 <br /> "ASS COUNTY COMMISSION <br /> COUNTY OF CASS, STATE OF NORTH DAKOTA <br /> . 7- / <br /> (Date of Application) <br /> This permit is issued to: <br /> S-7". /ziz. j=/2 a/CX f <br /> (Name) <br /> /0 fay f- f <br /> (Street Address) <br /> //A,9 //!, 3—ko 17 <br /> (City, State, Zip Code) <br /> (7o/J j yo2v <br /> (Telephone Number) <br /> giving them the right to shoot and display fireworks on the 3 '9( day of <br /> 1 t A Y , 20 y at 9 : 66 o'clock PM at the location of <br /> /090 ' 3 yL J7 f ,1% L A/O .SJ1oy7 <br /> in said Cass Coun No Dakota. <br /> Signature of Applicant <br /> Title of Issuing Officer <br /> By <br /> Signature of Officer <br /> Issuing Permit <br /> J:IAUIDITOR\SCHEPP\FIREWORKS PERMIT.doc <br />