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9/19/24, 10:35 AM Revize Online Forms <br /> Request has been sucessfully updated. <br /> Advisory Boa rd/Com mittee/Com mission <br /> Application <br /> � —1 <br /> Submitted by: amber urlacher <br /> Submitted On: 2024-09-18 15:10:25 <br /> Submission IP: (71.24.226.85) <br /> proxy-IP (raw-IP) <br /> Status: Open <br /> Priority: Normal <br /> Assigned To: Barb Benesch <br /> Due Date: Open <br /> MOUNDI <br /> VIEW <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 /> info(@moundsviewmn.org I www.moundsviewmn.org <br /> * First Name MI * Last Name <br /> amber urlacher <br /> Address * City State Zip Code <br /> 5406 Adams Street Mounds View Minnesota 55112 <br /> Phone Years in Mounds View * Email <br /> 6128599082 7 amber@grantjohnson.com <br /> valid email required <br /> Commission/Committee Applying For: <br /> ❑ Economic Development Commission (meets 3-4 times per year and as needed thereafter) <br /> O Planning and Zoning Commission (meets 1st and 3rd Wednesday at 6:30 PM) <br /> ❑ Parks, Recreation and Forestry Commission (meets 4th Thursday at 6:30 PM) <br /> ❑ Police Advisory Board (meets as needed) <br /> If applying for Economic Development Commission, check one box below: <br /> ❑ EDC - Resident Representative <br /> ❑ EDC - Business Representative <br /> If applying for more than one, please indicate your 1st, 2nd, etc. preference to serve: <br /> https://moundsviewmn.rja.revize.com/reports/629197 1/3 <br />