Laserfiche WebLink
CITY OF ELK RIVER <br />PERMIT APPLICATION <br />~.-1 FOR <br />.Y, <br />Ver COMMERCIAL KENNEL <br />~~~~ <br />~~~ <br />60o p~( <br />I_ `~ 2 <br />Full name of applicant ~.~ -" Y V~ ~ ~Gt ~ ~C.l, ~'~„ 1L.~-i J ~ t ~~ `~ <br />Address of applicant a 3 ~' J'~-- ~ ~ ~ b ` ~~,~ <br />(Street) (Cij) (State) (Zip) <br />Phone number of applicant ~~ ~~ ~~~f' <br />4. <br />5. <br />6. <br />Applicant is (check one): ~Indi~ridual ^ Corporation ^ Partnership <br />^ Other Organization <br />Indi~ridual: <br />A. If employed, name and address of emplo er ~a-~ ~ ~1 ~ lQ.,~C1 ~2 . / 3 O~ ~ y~ rd. <br />B. Have you ever been convicted of any crone, rrusdemeanor, or ~riolation <br />of any municipal ordinance relating to the care or treatment of animals? <br />^ Yes ~No <br />~rporation~Partnership, Other Organization: <br />A. Is the corporation, partnership, or other organization organized under <br />Minnesota lain? ^ Yes ^ No <br />If no, state in which organized <br />B. Is organization authorized to do business in Minnesota? <br />^ Yes ^ No <br />C. Attach copy of Certificate of Organization to transact business in Minnesota (received <br />from Secretary of States o~ce). <br />Attach list of the authorized agent or employee of the applicant who will transact <br />business in the City of Elk River on behalf of applicant including the fo1llowing 1 <br />information: ~u, ~ 1 L y 'p ~.,5 K~ ~. G, ~, a '(~ ,n, -- ~ -~"1' ~~ C,~-~L,C, <br />Name_ <br />Address <br />Phone # <br />8. Has the applicant or any other officer, director, partner, agent, or employee of the <br />applicant ever been con~ricted of a crime, misdemeanor, or violation of municipal <br />ordinances relating to the care or treatment of animals? ^ Yes ~ No <br />Address of commercial kennel Q ~/l,)lJ a' ~ 3 ~ ~ ~- ~ ~ ~ ~~ ~ l~ b v`Pi~ <br />SS~.33o <br />