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Email <br />ANNUAL CHICKEN & DUCK KEEPING <br />LICENSE APPLICATION <br />MOV7c <br />Ii JmcV!2401 Mounds View Blvd. I Mounds View, MN 55112 <br />L !' (763) 717-4000 1 Fax (763) 717-4019 <br />info(c7mou ndsviewmn. ora <br />Valid from January 1 — December 31 <br />Requirements relating to the keeping of chickens and ducks is located in Mounds View City Code Chapter <br />701.06. All permit holders are required to be familiar with the provisions of this chapter. In submitting a license <br />application, the applicant declares that they meet the requirements for issue of said permit, and that such <br />location will be operated in compliance with the adopted regulations and ordinances. All chicken & duck <br />keeping licenses are valid from January 1 through December 31 of each year. 'rhe application fee will not be <br />pro -rated and is non-refundable. <br />LICENSE FEE: NEW $100 X <br />Applicant Name: Pa Houa Shasky <br />Site Address: 2256 Lois Drive <br />Phone 1: 651-239-0038 <br />Email: phlee34@gmail.com <br />Signature of Applicant: <br />ANNUAL RENEWAL $30 <br />No site plan required for renewals) <br />Phone 2: <br />Does the applicant own the property where the chickens will be kept? yes <br />If the applicant is not the property owner, the owner must also sign this application. <br />Property Owner Name (if different from Applicant): <br />Phone 1: <br />Address/City/State/Zip <br />Phone 2 <br />Signature of Property Owner (Required if different from Applicant): <br />Number of Chickens: 3 <br />Number of Ducks <br />Total limit of 8 female chickens or ducks allowed - the keeping of roosters or drakes is prohibited <br />AFFICE,USE FEE PAID: $ jo CHECK # ,, 5 CASH/CREDIT: <br />SITE PLAN new only) RECEIVED: 5 —Le -a a SITE PLAN APPROVED BY: <br />TrtecwT ocncnr. nnnr+ r,rarr. <br />COMMENTS: <br />PUBLIC HEARING DATE new applications): DATE RECD. RECEIPT: <br />CITY COUNCIL DATE new only): APPROVED/DENIED <br />ADMINISTRATIVE APPROVAL (renewals): APPROVEDMENIED