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10/19/23. 10:02 AM <br />Request has been sucessfully updated. <br />Revize Online Forms <br />Advisory Board/Committee/Commission <br />Application ��nt <br />Submitted by: Dennis Farmer <br />Submitted On: 2023-10-19 09:46:53 <br />Submission IP: (66.41.157.212) <br />proxy-IP (raw-IP) <br />Status: Open <br />Priority: Normal <br />Assigned To: Barb Benesch <br />Due Date: Open <br />ADVISORY BOARD/COMMITTEE/COMMISSION APPLICATION <br />2401 Mounds View Boulevard * Mounds View MN 55112-1499 <br />(763) 717-4000 * Fax (763) 717-4019 <br />infoPmoundsviewmn.org I www.moundsviewmn.org <br />* First Name MI * Last Name <br />Dennis V Farmer <br />Address City State Zip Code <br />5117 Irondale Road Mounds View CA 55112 <br />Phone Years in Mounds View * Email <br />6128678293 19 dennis.farmer@gmail.com <br />valid email required <br />Commission/Committee Applying For: If applying for <br />❑ Economic Development Commission (meets 3-4 times per year and as needed thereafter) Economic <br />C/ Planning Commission (meets 1st and 3rd Wednesday at 7:00 PM) Development <br />❑ Parks, Recreation and Forestry Commission (meets 4th Thursday at 6:30 PM) Commission, <br />❑ Police Advisory Board (meets as needed) check one box <br />below: <br />❑ EDC - Resident <br />Representative <br />❑ EDC - Business <br />Representative <br />If applying fore more than one, please indicate your 1 st, 2nd, etc. preference to serve: <br />https://moundsviewmn.rja.revize.com/reports/403475 1/3 <br />