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VNmm��i�; � � / <br /> ''" r ' � <br /> � <br /> ��� � <br /> II /► .. �` , , � <br /> �' � D ti )^ ,� ' <br /> Conqtc�of�ntereat is de�'itted as�'ie participation in an activi r <br /> qr decision from which the individu�)b�as or could have the}�tentiale�e�iv�a`p��nal <br /> gain,whe.ti�er it is direct or indirect.In accordance with this definition,do you hav�any <br /> 1ega1 or eqtiitable interest in any business which could be construed as a conflict of <br /> interesf? Yes �No . <br /> �Y��I���details on�separate piece nf paper. <br /> � <br /> APplicaat Si -L� 'o�D��.�- G�� <br /> �ate `' <br /> Q��o�s maY be directed to the City Administtation Office at 21&568-5222. <br /> Return Completed Applicatio�n#o: City of Pec�uo,t Lakes <br /> t <br /> ; Ci.tY Ac�sinistr�tor <br /> 4b38 Ma�n�treet <br /> Pecitwt Lakes,MN 56472 <br /> � &mail:n�;at �e�chaCa3ned�ak��ov <br /> Website:�rav_x�eeunra��� �;, <br /> OFFICE tJS�ONLY , . <br /> 7bo Applicant Ia: __,__, New�°IPP�icant <br /> APP�Ying for R�nppofntment <br /> �ouadl Actioa• NotAppoipted <br /> A.ppc►3nted to: <br /> Date Appoiated: <br /> Term E�ires: <br /> S:1Admiuietra6onlCiiy CkrklBaaMs and CommiuianlApplintion Nrocpe and FomxlFomreWppiication Fuem fur Boa�ds and Co�runiuiuns.duc <br /> Page 3 <br />