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'i'l I (:hi l' OF <br />LA K E ELM <br />Lake Elft City Hall <br />• i <br />e ! <br />I hereby affirm that I am the fee title owner of the below described property or that I have written <br />authorization from owner to pursue the described action. <br />Name of applicant I <br />(Please Print) <br />Street address/legal description of subject property' , 3, , <br />OF THE WEST HALF OF THE SOUTHEAST QUARTER OF SECTION 16, TOWNSHIP 29 NORTH <br />LAKE MN 55042 <br />ignature <br />or r copy of your • r e to pursue o <br />Date <br />If a joint venture or partnership is the fee owner, attach a copy of agreement authorizing this action o <br />behalf of the joint venture or partnership. <br />11 <br />