EXCAVATION PERMIT

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PERMIT # ______________
FOR A PERMIT COVERING WORK AS SPECIFIED BELOW FOR:
BLACK JACK, MO 63033
I AGREE TO DO ALL THE ABOVE WORK IN STRICT ACCORDANCE WITH ABOVE STATED PROVISIONS AND WITH CITY ORDINANCE NO. 79
EMAIL ALL SUPPORTING DOCUMENTS TO DEPUTYCOURTCLERK@CITYOFBLACKJACK.COM
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FOR OFFICE USE ONLY DO NOT WRITE BELOW THIS AREA
 
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