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Exhib�A <br /> Fmtr«u�t rleami DM�on <br /> �/�/�w, �, f:b E PAR T M E M T D�ktn9 H►emer Prat�on se�ior► <br /> ■ ■ ■ i CiF HBA4TH P•�•�� <br /> sr.�,�sn�-or�s <br /> Phnm:631-2Q1�I900 <br /> Soacce W�tter Proteciion Plan Im lementation Graat Invoice <br /> �Ru��n�u��an �rs�:�oo�s <br /> Name:P Lak� NIN <br /> Address:46�MaU Sb'eet L.� MN 56472 <br /> Corrta�PerSon IVame•14rtdtew Sdtrvattr <br /> w�one:3zazsz 5T87 ra�c: <br /> Emai!•art . maiLcom <br /> ItiI1/O�CF�RMA7�ON <br /> Ls tt�is the flnal inwioe? � Yes ❑ No <br /> YYORK IiEl�IS 11ND D(PENDI7URE DE9�PTIQN—use an a�at if neaessa <br /> Rernave artd re laae 2—4'fla d�edc valres and 2—2'atr vacuum valves 5150.00 <br /> Total6cpe�d�ures $ <br /> Net Imoiae Aniount to 6e Pald 15�.00 <br /> DI9Cl.AtMER AND SLGNA71lRE I dede�e ida2 ro part dtdis dahn I�as been P�V b�ed bo 1�1�f,�d tl�itlie Toml E�tt�u�s rettect onN <br /> d�arges tffibed 1D ihe s0uoe vrd�p�oGeWon Pm1ecG I afso dedare tl�aRthe Qa1a m tlds doom�ertt LS aDrre��d aQ tr�that suppat th(s dalm were <br /> nnde In aaoordanae wIfi ail ap�able Federai and Ste�e�and regulatlats. <br /> autl�ized cranbee sig�uie � aahe � /,� t 9 <br /> F�OR�TA DEPARtMENT OF HEIILTN IISE ONLY <br /> C�a�Matiagec Sigrtatune D�be <br /> � �� <br /> Peniod d Se�iae: D�ate seet UUu F.M: <br />