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Note: Applicant to complete all lines, except last two, which will be completed by issuing officer. <br /> Enclose $2.00 permit fee in accordance with North Dakota Century Code 23-15-03 and <br /> return to Cass County Auditor, P.O. Box 2806, Fargo, ND 58108. <br /> <br />APPLICATION/PERMIT FOR FIREWORKS DISPLAY <br />FOR ENTERTAINMENT PURPOSES <br /> <br />COUNTY <br /> <br />This permit is issued to: <br /> <br /> y <br /> <br /> (Name) <br /> <br />(Street Address) <br /> <br />(City, State, Zip Code) <br />(Telephone Number) <br /> <br />~'//~ ,2002 <br />(Date of this Application) <br /> <br />giving them the fight to shoot and display fireworks on the <br /> <br /> day of ,20 o~,~. at ~: ~' o'clock PM <br /> <br />at (location): <br /> A:',,'>. /7 <br />in said ~/9,~_~q-_q- County, North Dakota. <br /> <br />~ ~amr~ of Applicant <br /> <br />Title of Issuing Officer <br /> <br /> By <br /> Signature of Officer <br />SUGGESTED MOTION: Issuing Permit <br />Move to approve the permit for a fireworks display for entertainment purposes, <br />according to an application submitted by Jerry Black, 6810 Golden Spike Road, Fargo, <br />ND, on the date ofthe4th of July, 2002, at 9:00 PM. <br /> <br /> <br />