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Dated <br />(Here state other requirements of local regulation., if any) <br />*tate of ftlitmeoota, } 88 <br />COUNTY OF ba- 0-fec <br />,¼rve» 2 47; r„5. 0 kk <br />„ <br />being duly sworn, on oath, say.. that <br />the within, applicant ; that he ha fall and first hand knowledge of the facts stated in <br />the within application, and of the business of said applicant , the location thereof, and the contents <br />of the within application; and that the statements made in said application are true of <br />own knowledge. <br />Subscribed and Sworn, to Before <br />Me this -7741 day of &Celt/Jr/ <br />Notary Public 49 <br />.41y Commission Expires <br />RPPLICRTION OF <br />et) <br />JON D. OLS(T"N"In <br />MITANY PUOL/C-MINNESOO <br />DAKOTA COUNTY i <br />ilkeemm. . Expires Jan. St 2000 1 <br />.e2 06e) <br />Page 71 <br />4 <br />