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Chicken/Duck Keeping License Application <br /> Del <br /> Submitted by:Cally-Ann Jacobson <br /> Submitted On:2026-03-28 21:30:13 <br /> Submission IP: 24.118.112.22(172.31.29.42) <br /> proxy-IP(raw-IP) <br /> Status:Open <br /> Priority: Normal <br /> Assigned To:Barb Collins <br /> Due Date:Open <br /> Attachments <br /> • -'QQ Site Plan.psIt-2026-03-28 09:30:14 pm <br /> ANNUAL CHICKEN/DUCK-KEEPING <br /> 11 LICENSE APPLICATION <br /> MO� �mC VMW 2401 Mounds View Blvd.I Mounds View,MN 55112 <br /> lJl r1JJ iL (763)717-4000 1 Fax(763)717-4019 <br /> infcrr;mnund5vie.vrnnArq <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 /> rd New Application$100(Site Plan Required) Chickens #of Chickens #of Ducks <br /> ❑ Renewal Application$30 Ducks I , <br /> Applicant First Name `Applicant Last Name 'Email <br /> Cal,•; �. Jacobson callyy268@gmail.com <br /> Valid Email Required <br /> Street Address City State Zip Code <br /> 7338 Silver Lake Rd Mounds View MN <br /> Phone 1 Phone 2 <br /> 612-619-9859 612-413-62% <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 />