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`l <br /> CIVIC AND COMMUNITY ACTIVITIES: <br /> Describe past or present civic and/or c mmunity activities that ma be relevan in qualifying you to QV I serve on this board or commission. � <br /> ('24 � <br /> h4 lid 9,01 441 ep fv)l <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: /V Yes _No A , <br /> -h &,—t Comments: A(e� c dl' 4� <br /> 0 <br /> CONFLICT OF INTEREST: <br /> I wish to disclose the following potential conflicts of inte est that may or wil arise if I become a <br /> member of this commission. <br /> Sig ature Ifate <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 /> P.O. Box 361 Term Length: <br /> 31108 Government Drive <br /> Pequot Lakes, MN 56472 <br /> Phone:218-568-5222 Page 2 <br /> Fax:218-568-5860 <br />