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Advertisement Details <br />Will this device be located within tribal lands? <br />❑ Yes ® No <br />If yes, select tribe from the menu: <br />❑ Bois Fort Band of Chippewa ❑ Fond du Lac ❑ Grand Portage Band of Chippewa <br />❑ Leech Lake Band of Ojibwe ❑ Lower Sioux Community ❑ Mille Lacs Band of Ojibwe <br />❑ Prairie Island Indian Community ❑ Red Lake Nation ❑ White Earth Band of Chippewa <br />['Shakopee Mdewakanton Sioux Community <br />Zoning Authority <br />City: Ramsey County: Anoka Township: Ramsey Historical <br />Zoning Designation <br />❑ Residential ❑ Agriculture ❑ Industrial ® Commercial ❑ Unzoned/Commercial <br />Advertising Area (Including Border & Trim) <br />Height: 39' Width: 15' Square Feet: 585 <br />Device <br />Illuminating: ® Yes ❑ No <br />Type: ❑ Single Face ❑ Side -by -Side ❑ 'V' Type <br />® Back -to -Back ❑ Over Under ® Electronic <br />Distance <br />From center of highway to nearest corner of device = 89 Feet <br />Right of Way at sign site = 2114 Feet <br />Date the device will be/was erected on <br />NOV 1, 2022 <br />Landowner, Lessee or Agent must submit letter granting use of property or sign item below. Letter attached: <br />® Yes ❑ No <br />Signature Date of Signature <br />See letter attached - Roman Gadaskin 7/25/2022 <br />I, We, the undersigned, hereby declare that all statements herein are true and complete, with the same force and <br />effect as though given under oath, herewith accept the terms and conditions of the regulations of the <br />Commissioner of Transportation and fully agree to comply there with the satisfaction of the Minnesota <br />Department of Transportation. <br />Signature <br />Paul T. Hilt <br />Date of Signature <br />7/25/2022 <br />2 <br />