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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 commi ion. t- os -rar h q s keen en o%ali4� w;t4e 1and <br /> �,� �,-,C� civic, i�t �vl�e�vt.er� <br /> pie u�lo(I�citenrt11 <br /> 4 O ' ✓e4*d L" a -�tm IyDkyv-���Ja J ky, d o �e� cy-cla 1(7 l�-ae dF/V <br /> S 4 <br /> 2f -(27y- Mi2ll y 041 y6ft f 7e end /-earmeof Ia; ;� A0&e- �?:,o <br /> � <br /> d <br /> � / a (e . d o 65�v �Y Ce 4 ;ocll/u s � <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: -t- Yes _No <br /> Comments: P�� v �o r%s tear My wodz- has keOt me -rem <br /> 4;✓Ind r12ce SSac <br /> ��'✓ a��(I r dl-e 4( com 77<<-vre: S Siuc� `?u�� p't'td <br /> MCI wor1L sGiedr�raN ;� ,�iZciuf'rrcr( --,I— "nw A'Ve -/A'C --frame c(Ucc lcc���Q <br /> �o r ales �eceSSclvy -�i�►�c C�1✓yt/� i� j-7ketr ez.-ea S . <br /> CONFLICT OF INTEREST: <br /> I wish to disclose the following potential conflicts of interest that may or will arise ' I beco e a <br /> member of this commission. We- c2cv 1 7 T 2 �� vh 42-el'f Cuj- ql-�K�9 � � <br /> jv`e � `7-�u Pd Sam P �✓vvt d{ �/Qc�lo� Of <br /> Sig ture Date <br /> THANK YOU FOR YOUR INTEREST IN SERVING ON THE PLANNING AND ZONING <br /> COMMISSSION. <br /> OFFICE USE <br /> Return Application To: Appointed To: <br /> City of Pequot Lakes Date Appointed: <br /> City Clerk's Office <br /> 4638 County Road 11 Tam Length: <br /> Pequot Lakes,MN 56472 <br /> Phone:218-568-5222 Page 2 <br /> Fax:218-568-5860 <br />