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CIVIC AND COMMUNITY ACTIVITIES: <br /> Describe past or present civic and/or community activities that may he relevant in qualifying you to <br /> serve on this board or commission. <br /> Jenkins Township Supervisor (Elected) 18 yrs. Pequot Lakes Fire Board - 15 yrs. <br /> Cable Commission (since inception as Interlake Cable) Region .5 Commissioner — 6 yrs. <br /> Transportation Committee/ Crow Wing County Advisory Group 5 yrs. Greater River Housing <br /> Group/ Region 5 - 5 yrs. Minnesota Board on Aging Advisory Group -1 yr. Crow Wing <br /> County Health Advisory group =- S yrs. Crow Wing County Twsp Officers Member, Pequot Lakes <br /> A MA r, PLADO Member, NAHRO Member,Central MN Housing Group Member. CWC HRA <br /> Commissioner - 6 yrs. Trustee/ Our Savior's Lutheran - 3 yrs. <br /> Are you aware of the importance of regular meeting attendancc 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: X Yes _No <br /> Comments: I am unavailable for meetings on most Tuesdays, some Mondays and some Thursdays, <br /> but would be available for Planning and Zoning meetings on the third Thursday of each <br /> month, and for special meetings as needed. I have resigned from Region 5 Commission, havin <br /> served 6 yrs. I am ready for a new challenge, closer to home. I dedicate myself to any <br /> service group or member group to which x am elected, appointed or asked to serve on. <br /> Planning and Zoning will be a new experience and challenge for me and one that I would <br /> look forward to. <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. My husband and I own a forty acre parcel east of old 371 on <br /> Ackerson Rd. (formerly in Sibley Twsp.) and we also own a rental property at 3905 Brown St <br /> in Pequot Lakes. The land parcel may be impacted by the potential bypass option being <br /> considered by MNDOT. In the event that any of our personal property should be brought befo <br /> the Planning and Zoning Commission for consideration_ I would be willing to remove myself <br /> from ing. /We h ve hidden agendas or considerat'ons tied to this application of <br /> service. <br /> Signature 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 /> 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 />