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CIVIC AND COMMUNITY ACTIVITIES: <br />Describe past or present civic and/or community activities that may be relevant in qualifying you to <br />`-- serve on this board or commission. <br />Crow Wing County HRA Commissioner; Pequot Lakes Advisory Board Member of the Brainerd Lakes <br />M <br />Area Chamber of Commerce; <br />Past: <br />ATTENDANCE: Shepherd of the Hills Lutheran Church — Councilmember; Creekside of Plymouth Townhouse <br />Association - Treasurer <br />Are you aware of the importance of regular meeting attendance including the time commitment <br />involved in pre aring for meetings, and do you feel you have the time available to be an active <br />participant: Yes _ No <br />Comments: <br />CONFLICT OF INTEREST: <br />I wish to disclose the following potential conflicts of interest that may or will arise if I become a <br />member of this commission. <br />(700& <br />Signature Date <br />THANK YOU FOR YOUR INTEREST IN SERVING ON THE PLANNING AND ZONING <br />COMMISSSION. � o /o/ u A F,• / / 0 %1'4ej iU <br />Return Application To: <br />City of Pequot Lakes <br />City Clerk's Office <br />4638 County Road I 1 <br />Pequot Lakes, MN 56472 <br />OFFICE USE <br />Appointed To: <br />Date Appointed: <br />Term Length: <br />Phone: 218 - 568 -5222 Page 2 <br />Fax: 218 - 568 -5860 <br />