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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 />__J_ <br />4'VV'kk 07t- <br />ATTENDANCE: <br />Are you aware of the importance of regular meeting attendance including the time commitment <br />involved in preparing for meetings, and do you feel you have the time available to be an active <br />participant: 'k Yes _ No <br />11%.,. <br />Comments: <br />S—J I <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 />Signature Date <br />THANK YOU FOR YOUR INTEREST IN SERVING ON THE PLANNING AND ZONING <br />COMMISSSION. <br />Return Application To: <br />City of Pequot Lakes <br />City Clerk's Office <br />4638 County Road 11 <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 />