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ANNUAL CHICKEN & DUCK KEEPING <br />MovNDS I� LICENSE APPLICATION <br />Valid from January 1 — December 31 <br />Requirements relating to the keeping of chickens and ducks is located in Mounds View City Code <br />Chapter 701.06. All permit holders are required to be familiar with the provisions of this chapter. In <br />submitting a license application, the applicant declares that they meet the requirements for issue of <br />said permit, and that such location will be operated in compliance with the adopted regulations and <br />ordinances. All chicken & duck keeping licenses are valid from January 1 through December 31 of <br />each year. The application fee will not be pro -rated and .is non-refundable. <br />LICENSE FEE: NEW $100 _ ANNUAL RENEWAL $30 <br />Applicant Name: U q 60L k-0 C j <br />Site Address: <br />Telephone: Home Cell: <br />Email: <br />Signature of Applicant: <br />Does the applicant own the property where the chickens will be kept? <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 />Address: <br />Telephone: <br />Signature of Property Owner (Required if different from Applicant): <br />Number of Chickens: —� Number of Ducks: <br />a <br />Total limit of 6 female chickens or ducks allowed - the keeping of roosters or drakes is prohibited <br />Date received: <br />Site Plan Received? <br />OFFICE USE ONLY <br />Fee Paid: CHECK # <br />Site Plan Approved By: <br />Police Department Review: APPROVE or DENY <br />Police Dept. Review Approval: <br />Public Hearing Date: <br />City Council Action: APPROVE or DENY or Administrative Approval <br />Issued License Number: <br />/ CASH / CREDIT <br />