Laserfiche WebLink
JAMES METZEN MIGHTY DUCKS <br /> GRANT APPLICATION 001 if%��Nrc�i`rrrtr <br /> i !/ f <br /> fll <br /> Type of Application; (check one) <br /> Indirect R-22 EliminationD�ireet R-22 Elimination //jlllll' 11Jj � <br /> [ ] Indoor Air Quality Improvement <br /> Local Government Unit(LGU) <br /> LGU Application Contact (Name, Title, Address, Email &Telephone) <br /> V �. <br /> Project Name and Ply tic tAddress <br /> (' t5 of tS i v- r),.rm i n C n 4 ,i,, <br /> w <br /> Primary Contact(Name, Email & Telephone) <br /> Minnesota Tax ID Number <br /> Federal Employee ID dumber <br /> Minnesota Rouse of Representatives District Number of Facility <br /> IncludeProject Documentation found at b����u��i�Qer�a,,��n gtm�g[gy d�r�a,ks.SLI11. <br /> EXECUTION: <br /> IN WITNESS THEREOF, the applicant has caused this application to be executed on the <br /> day of 2016. <br /> By: (Authorized Signer) (Title) <br /> Mail three originals of this form to: <br /> Minnesota Amateur Sports Commission <br /> 1.700 105`"Avenue NE, Elaine MN 55449-4500 <br />