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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 this board or commis'si'o <br /> �wA A47 Am, 1f9�—gG (��y� Sc�i�vl��ry �_ �Dr•�rs <br /> PLADo -ea4-6 oa d wa4 w, cvvwd mep%4 e,,,- <br /> P"trs, -94g72, Air G'wft4 <br /> ATTENDANCE: <br /> Are you aware of the importance of regular meeting attendance including the time commitment <br /> involved in prep5;ing for meetings,and do you feel you have the time available to be an active <br /> participant: V 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 /> � y � <br /> Signature Dad <br /> THANK YOU FOR YOUR INTEREST IN SERVING ON THE PLANNING AND ZONING <br /> COMMISSSION. <br /> OFFICE USE <br /> Return Amlication To: Appointed To: <br /> City of Pequot Lakes Date Appointed: <br /> City Clerk's Office <br /> 4638 County Road 11 Tam ieagh: <br /> Pequot Lakes,MN 56472 <br /> Phone:218-568-5222 Page 2 <br /> Fax:218-568-5860 <br />