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LAKE <br />ELMO <br />Please, PRINT <br />Name: <br />City of Lake Elmo <br />REQUEST TO APPEAR <br />Before the <br />City Council or Planning Commission <br />ii t ch C) I's � <br />Address: t 1 <br />16 <br />Agenda Item/Subject: <br />Representing <br />Company/Individual: <br />V 1Fi1 n <br />Note: Please, complete this form you may be recognized at the appropriate time. You are under no obligation to speak if you <br />change your mind during the meeting. Please, state your full name and address for the record. Thank you. <br />