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/ r•. $30. 00 <br /> CITY Cr S T. ANTWOMY • <br /> APPLICATION-1'90 LI CVx SZ <br /> Article NO. Section No. Date <br /> KAY¢ Albers Construction hereby cubmits application for licence to <br /> perform within the :ity of St. Anthony in accordance with <br /> -the code of ®aid City requlatinq tha same. <br /> Submittinq, along with this application, !e a $ ,000 License/Permit Bond <br /> (March 15 to Karch 15th conc-srring with licence year) payable to the City of St. Ant.horty, <br /> conditioned upon cocrliance with the applicable code of said City, and Certificate of <br /> Insurance in the limits of 5100.000 per person, $300.000 per accident for bodily <br /> in3ury and $5..000 for property d=%age, and a Cartificate of Insurance evidencing tho <br /> the holding of workman's Copensatlon as required by 1son. <br /> Company or Fir. N--%r - Albers Construction <br /> Address 3636 Regent Ave. North City Aobbinsdale_ MLN ZIP 55422.. <br /> Telephone N ►,er 612-588-5216 • <br /> Company agent or o' .' :clal 1 . <br /> State Master L:.enlle No. <br /> Llcer.scs :n reArby �:1 ' 1( s ' rr state <br /> APPLICJ.N'TS ( in Full) <br /> (Print) <br /> AP P L I CA.ti'T5 S I G t1ATU RE <br /> (DO NOR' W RS TE IN SPACE BZ LOW) <br /> Amount $ DEPAMM" REPORT <br /> note <br /> &LtisLpt DO. 9`•� <br /> tt�tisarco <br /> fdcmn" ito. <br /> A''PROV)LL • <br /> o <br /> DENTAL <br /> PY � <br />