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MINNESOTA DEPARTMENT OF AGRICULTURE <br /> DIVISION OF PLANT INDUSTRY <br /> 670 State Office Building <br /> St. Paul, Minnesota 55155 - <br /> GRANT-IN-AID APPLICATION <br /> RESIDENTIAL PROPERTY TREE REMOVAL SUBSIDY t <br /> . FOR STATE USE ONLY <br /> Date Received Contract # <br /> Application # Requisition # <br /> Date of Award Date of Encumberance <br /> PART I - GENERAL INFORMATION <br /> (1) Political Subdivision Applying; i (2) Program Manager - Person to whom <br /> Name: inquiries about the application <br /> City of St. Anthony . 1 <br /> should be directed. <br /> • Address: 3301 Silver Lake Road i Name: Jerry Dulgar <br /> Minneapolis, MN. 55418 i <br /> County: Hennepin & Ramsey Title: City Manager <br /> Address: 3301 Silver Lake Road <br /> Phone; Minneapolis , MN. 55418 <br /> 789-8881 <br /> (3) Individual authorized to act in ' (4) Tree Inspector responsible for <br /> behalf of the applicant: certification of eligible trees: f <br /> i <br /> Name: Jerry Dulgar Name: Larry Hamer <br /> I <br /> Title: City Manager Address: 3301 Silver Lake Road <br /> Minneapolis, MN 55418 <br /> Address: 3301 Silver Lake Road Phone: 789-8881 <br /> MP1s.MN. 55418 _ <br /> Phone: 789-8881 Status: ) Certified I <br /> ( ) Provisional f <br /> APPENDIX A: Please include evidence <br /> of certification. <br /> (5) Fiscal Agent to whom check should be issued. <br /> I <br /> • Name: I <br /> Carol B. Johnson Address: 3301 Silver Lake Road <br /> Title: Clerk/Treasurer Phone: 789-8881 <br /> Payee's' Title: <br /> 8/75 AGR 36 <br />