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1/13 Page 2 of 2 <br />LG220 Application for Exempt Permit <br />LOCAL UNIT OF GOVERNMENT ACKNOWLEDGMENT <br />0 <br />Cll 0. <br />j .EcL <br />a 15. <br />acm <br />Z r y <br />O m ro <br />U L. O <br />CITY APPROVAL <br />The application is acknowledged with no waiting period. <br />o <br />0 m <br />C Qr <br />U <br />f0 <br />11)� <br />0 <br />o AI <br />n3'n <br />U U Cf0 <br />a <br />a -a <br />MI 0 ui <br />�a)n3 <br />H. a -0 <br />fn <br />ea <br />o ay,o <br />'L c M <br />a 'a L. <br />01 ro <br />in <br />c >. <br />3 :a' ro -a E <br />E oar <br />M 0_ <br />C 03 f0 <br />a,0 4) n <br />.0 O al O <br />.-0 -0 - <br />E � a) a) +� <br />O U <br />0 CD N <br />al 4.1- <br />io U U U <br />L. 0 <br />V MIf0 <br />O ,N z v) <br />c c O <br />r-I <br />o o (0 f0 <br />fP0 ( L <br />P 0 <br />o U C w <br />f0 Vl <br />a a + >. <br />O. a-U (o <br />!0 113 O -0 <br />_C _Ca)to <br />f- , H a ._ <br />The application is denied. <br />The application is denied. <br />a) <br />0 <br />L <br />a) <br />0. <br />a) <br />E <br />ro (0 O <br />N-- <br />O <br />o <br />03 <br />+- <br />fi 10 <br />Print city name <br />a) <br />fo <br />0 <br />eP <br />r- <br />ns <br />0 <br />ro <br />0 E <br />Li. w <br />E <br />L <br />QJ <br />0 <br />0 al <br />U <br />LC U <br />C a <br />O <br />a-+ .0 <br />f0 Li) <br />oC <br />O <br />fr.) <br />L a) L <br />o r 0 <br />_C C a) <br />44_, -j 2 to <br />0a ,-i . <br />44 o a1 <br />fs`5 o co <br />=(I)u .>1 <br />0 ro L 4- <br />C 0) ,c aO+ <br />l <br />� <br />fl (0 <br />s i ,-, E <br />O <br />as = a) <br />CA 4J ate+ c <br />C fn'z <br />Print township name <br />Signature of township officer <br />0 <br />CHIEF EXECUTIVE OFFICER'S SIGNATURE <br />