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Note: Applicant m conlplele all lines, except last two, which will be complelt-d IO' i,~guing officer. <br /> Enclose $2.00 permit fee lu accordance with North Dakota Centur? Code 23-15-03 and <br /> relmm to Cass Count' Auditor, P.O. Bnx 2806, Fargo, ND 58108. <br /> <br />APPLICATION/?ERMIT FOR FIREWORKS DISP[ ,AY <br /> FOR ENTER I'AINMENT PURPOSES <br /> <br />COUrCT','___ ~_ CCc? 5____STAr~ <br /> <br />~ Date of this Application) <br /> <br />]'his permit is issued to: <br /> <br />..... Ion <br /> <br />(Str~,c~ Address) <br /> <br /> CLe'fhu. r- <br />(City, State. Zip Code) <br /> <br />(I elephone Number) <br /> <br />gixing them thc right to shoot and display firrworks on II~e <br /> <br /> ~ __ day of \ LL_i"MO~_.. ,20 O~ at ~D;~ o'clock <br /> <br />at (location} ~E i ~' 0 <br /> <br />in said Q~.5 5 ____ County, N¢mh O~ota, <br /> Signature e f Ap~lic<t <br /> <br /> Title of issuing Officer <br /> <br />By_ <br /> Signature of Officer <br /> <br />SUGGESTED MOTION: <br />Move to approve a fireworks display permit for Roger A. Melvin, Wizard Works, Inc. at Page, <br />North Dakota, on the date of June 8, 2002. <br /> <br /> <br />