7.2. PRSR 02-11-2015 - Laserfiche WebLink

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g// City of Elk River Police Department CITY OF ELK RIVER 2015 LANDOWNER'S PERMISSION SLIP Full Name: Date of Birth: Phone number: Address: MN DNR# Driver's License# License Type (check all that apply): ❑ Small Game ❑ Waterfowl ❑ Turkey/Shotgun ❑ Turkey/Archery ❑ Deer(Archery) ❑ Deer(Shotgun Slug) ❑ Deer(Muzzleloader) HUNTER'S CONSENT I agree to abide by the rules established for hunting within the City of Elk River and I realize failure to comply will lead to prosecution under Section 50 of the City code,as it may from time to time be amended. I will carry this permission slip on my person at all times when hunting on this property. I will not discharge a firearm or bow closer than 500 feet from any inhabited structure without the written permission of the owner,occupant,or lessee of such structure. I will complete a HARVEST INFORMATION SHEET(if applicable) at the completion of the 2015 hunting season and return it to the City no later than February 1",2016. I understand that I must have the City issued back tag in my possession at all times when hunting within the City. Hunter's Signature Back Tag# LANDOWNER'S CONSENT I ,hereby authorize the above named hunter to hunt on my property located within the City's"no hunting"boundary during the 2015 hunting season. In granting this permission,I am not accepting any responsibility for or incurring liability for any injury to the person or property caused by an act or omission of the person (M.S. 604A.23). I further understand the City,likewise,accepts no responsibility or liability in regards to hunting game on my property. Landowner Name (Printed) Landowner Signature Address or Legal Description of Property to be Hunted ❑Approved [' Disapproved Designee Sergeant By Authority of Bradley R.Rolfe,Chief of Police