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City of Mounds View <br />2401 Mounds View Blvd <br />Mounds View. MN 55112 <br />CITY OF MOUNDS VIEW/ PERMIT 21-0 <br />Expires on /_/ <br />Pursuant to the rules and regulations of the City of Mounds View and the Rice Creek Watershed District policies <br />and standards, and based upon the statements and information contained in the permit application, letters, maps, <br />and plans submitted by the applicant and other supporting data, all of which are made part hereof by reference, <br />permission is hereby granted to the Permittee named below to conduct the activity described below. If an <br />extension to the permit is needed, the Permittee should submit a written request to the City at least 2 <br />weeks prior to the expiration date. <br />Name of Project <br />Project Description <br />Project Location <br />Permittee Name <br />Permittee Company <br />Permittee Address (No. & Street, City, State, Zip Code) <br />Permittee Phone <br />No. <br />Permittee Fax No. <br />Permittee Cell No. <br />Permittee E-Mail <br />In accordance with the attached plan received at the City on (date received): <br />.,uLIlul 1«U aIrpIQLUI <br />Date of Issuance:_-/2021 <br />Page 1 of 2 <br />