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CIVIC AND COMMUNITY Ai TIVITIES: <br /> Describe past or present civic and/or community activities that may be relevant in qualifying you to <br /> serve on this board or commission. <br /> 1 ¢usG..v�, Q�� <br /> ATTENDANCE: <br /> &rJ <br /> Are you aware of the impbttance 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: X Yes _No <br /> Comments: <br /> 0b,X /lA tx- ,13 41J 01"(J Iv � <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 /> po N 2. <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 />