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1/13/25,9734AM Revize Online Forms <br /> Chicken/Duck Keeping License Application <br /> Submitted by: patrick Engelmann <br /> Submitted On: 2025-01-13 09:31:05 <br /> Submission IP: (75.72.126.233) <br /> proxy-W (raw-IP) <br /> Status: Open <br /> Priority: Normal <br /> Assigned To: Barb Benesch <br /> Due Date: Open <br /> Attachments <br /> • iMG 3668.pdf - 2025-01-13 09:31:06 am <br /> ANNUAL CHICKEN/DUCK-KEEPING <br /> LICENSE APPLICATION <br /> M 0 IS <br /> VVI E AT 2401 Mounds View Blvd. I Mounds View, MN 55112 <br /> ■ (763) 717-4000 1 Fax (763) 717-4019 <br /> info@mvundsvie mn.vrg <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 90.005. All permit holders are <br /> required to be familiar with the provisions of this chapter. In submitting a license application, the applicant declares that they meet the <br /> requirements for issue of 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 each year. The application fee will not be <br /> pro-rated and is non-refundable. <br /> 0 New Application $100 (Site Plan Required) Chickens # of Chickens # of Ducks <br /> ❑ Renewal Application $30 ❑ Ducks 4 <br /> * Applicant First Name * Applicant Last Name * Email <br /> patrick Engelmann <br /> Valid Email Required <br /> Street Address City State Zip Code <br /> 8400 greenwood dr. mounds view mn 55112 <br /> Phone 1 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 Street Address City State Zip <br /> https-llmoundsvlewrnn.ria.revize.com/reporrs/713893 113 <br />