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Email <br />dustin,nyffeler@grnai Isom <br />Valid Email Required <br />" Phone 1 <br />7633604192 <br />Phone 2 <br />Ex. (123) 456-7890 <br />If the applicant is not the owner of the property, please complete the section below: <br />Owner Name <br />Rouen Eickstacit <br />Street Address <br />8136 Red Oak Dr <br />City State Zip Code <br />Mounds View MN 55112 <br />Email <br />fatq ua rterbnn n i e @y a hoo.eom <br />Valid Email Required <br />Phone T Phone 2 <br />7637866236 Ex, (123) 45 6- 7890 <br />PRIVACY NOTICE: I understand the information provided in this form may be considered private or confidential data. I further understand that I may not be required by law to provide <br />such informatl on. The purpose of providing such information is to aid the City in its determl hation on said application. I acknoWledge that providing, or fain hg to gravid e, such <br />information may affect the City's detennination on said application. I understand this information will be made available to the Clty of Mounds View, its City Council, agents and <br />representatives, as well as the Minnesota 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 from any and all liability for its receipt and use of data received pursuantto this application. <br />" Applicant Signature Date <br />Dustin Nyffeler 04/02/2023 <br />Format: MMIDD/YYYY <br />Owner Signature [if not applicant] ' Date <br />Robert Eickstadt 04/02/2023 <br />Format: MMIDDIYYYY <br />REQUIREMENTS FOR KEEPING AND RAISING OF HONEY BEES <br />