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Government Lot, Fractional Section <br />or Other Subdivision <br />Section <br />Township <br />Range <br />County <br />Right <br />of wa Pole <br />Width leight <br />Name of <br />Lake or Stream <br />Leagtt <br />SE 1/4 of SE 1/4 <br />8 <br />30N <br />24W <br />Ramsey <br />72' <br />20' <br />Rice Creek <br />%,129 IINNESOTA CONSERVATION DEPARTMENT <br />60 Waters <br />Division of <br />Submit in Quadruplicate <br />To: Commissioner of Conservation, State Office Bldg., St. Paul 1, Minnesota <br />Located as described below: <br />APPLICATION FOR PERMIT <br />To Cross State Lands and Public Waters Pursuant <br />to M.S.A. 84.415, and other Applicable Statutes <br />Village of Mounds View <br />Name of Applicant <br />Address <br />The applicant herein applies herewith for a permit to construct, operate and maintain the following: <br />(Check applicable blocks in each section below) <br />communication Line <br />Roadway <br />0 Power Transmission Line <br />El Railway <br />J Pipe Line <br />0 Ditch <br />0 Over <br />[l Under <br />El Across <br />G Land <br />0 <br />Lake <br />Stream <br />All in accordance with the plans, specifications and other supporting data attached hereto, which informa- <br />tion is made a part of this application. The applicant declares that the information submitted herewith and <br />the statements made herein are true and a correct representation of the facts, and that the filing of this <br />application and information with the Commissioner of Conservation is prima facie evidence of the correctness <br />thereof. <br />Attach details of proposed work, maps, plans, and other su porting data.) <br />For over crossings, the width shall be at least twice the height of the line supports. <br />(SIGNATURES AND ACKNOWLEDGMENT ON REVERSE SIDE) <br />