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<br />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 />Cenlury Code 23-15-03 and return to Cass County Auditor, P.O. Box 2806, <br />Fargo, ND 58108. . <br /> <br />APPLICATION/PERMIT FOR FIREWORKS DISPLAY <br />FOR ENTERTAINMENT PURPOSES <br /> <br />COUNTY OF CASS, STATE OF NORTH DAKOTA <br /> <br />3-,;2 V- oS <br />(Date of Application) <br /> <br />This permit is issued to: <br /> <br />S/AR~ FI/ZEt-JO~/C" S <br />(Name) <br />3g'05 52.;?3 AvE S <br />(Street Address) <br /> <br />F,qR60 IV!) S-P/o t/ <br />(City, State, Zip Code) <br /> <br />(701) tltfz-- b3t'f <br />(Telephone Number) <br /> <br />'7.JA <br />giving them the right to shoot and display fireworks on the - day of <br />Q' b <br />/11/9 '/ , 20 0:> at /. () o'clock PM at the location of <br /> <br />3~oS- S-::2d j4Vf: S H/c6o ,Nj;) S'cfJo)/ <br /> <br />in said Cass Count , North Dakota. <br /> <br /> <br />Signature of Applicant <br /> <br />Title of Issuing Officer <br /> <br />By <br /> <br />Signature of Officer <br />Issuing Permit <br /> <br />SUGGESTED MOTION: <br />To approve a permit for fireworks display to be held at 9:00< PM on May 7, 2005, at Starr Fireworks, <br />3805 52nd Avenue South, Fargo. <br />