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If the applicant is not the owner of the property, please complete the section below: <br />Owner Signature (if not applicant) <br />Laura Maldonado I Si —/ �" ' 07/16/2022 <br />Owner Name <br />Laura Maldonado [managed by daughter. Andrya Clietc•• <br />Street Address <br />5219 Jeffery Dr <br />City State <br />Mound View <br />Email <br />andrya dieter gmail com <br />Zip Code <br />MN 55112 <br />Phone 1 Phone 2 <br />7634781283 <br />PRIVACY NOTICE I understood the Idelfeetkle provided in tldr form may be considered onyx!, or confidential data. I further understand that I may not he required by law to provide <br />idr irdnnnatfort The purpose aF p►tnl rl0 path fnkywwtion is to aid the City in its determination on said application. I acknowledge that providing, or tailing to provide, such <br />Irrlarrwadws shay a ttect the City's de1epwYrNlon on said+applicatiun. I understand this intamratim will be made available to the Crty of Mounds View, its City Council, agents and <br />nproatn4flyu. . was IN the hhhelelete Department of Revenue, the Internal Revenue Service, or any other person or entity authorized by law to receive said information. I release the <br />City of Mounds View Irani any end d liability For ii rereJpt and use of data received pursuant to this application. <br />Applicant Signature Date <br />Rebecca Whitehead 07/16/2022 <br />Forman MMvDDNYYY <br />Date <br />Format- M .i1DD.Nrer <br />PAYMENT CAN BE MADE AT BOTTOM OF PAGE <br />UMIT OF 8 FEMALE CHICKENS OR DUCKS OR COMBINATION OF BOTH_ THE KEEPING OF ROOSTERS OR DRAKES IS PROHIBITED <br />• Public Hearing Required for New Applications. The City will notify you of the date and time of the hearing. Your attendance at the <br />meeting is recommended. <br />. Site Plan Showing Coop Setbacks from Property Lines is Required for New Applications <br />Upload Site Plan <br />Choose File] No file chosen <br />REQUIREMENTS FOR KEEPING AND RAISING CHICKENS AND DUCKS <br />Chicken and Duck Permit Requirements: <br />1. Located on single-family residential properties only <br />