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5.2. SR 09-21-2009
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5.2. SR 09-21-2009
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9/23/2009 2:18:07 PM
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9/18/2009 1:59:47 PM
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SR
date
9/21/2009
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~~~~ <br />CITY OF ELK RIPER Q~'~; <br />PERMIT APPLICATION ~ <br />;. ~„~ - FOR a <br />.1VE'.r COMMERCIAL KENNEL <br />~~'' `,-. <br />1. Full name of applicant ~ ~ ~ ~ t~ ~ ~~.1~ t-~AA , -~.-~-t J ~ ' ~~, `~ ~`~ L <br />2. Address of applicant a 3 ~' ~ ~ ~ ~ b ' E~,~ <br />(Street) (Cif) (State) (Zip) <br />3, Phone number of applicant ~~~i" ~~~' 3 7 <br />4. Applicant is (check one): ~Indi~ridual ^ Corporation ^ Partnership <br />^ Other Organization <br />5. Indi~-i dual: <br />A. If employed, name and address of employer ~°-~ ~ 1.1 ~ ~~C~ ~ . ~ 3 O~ ~ ~~ ~:~ <br />B. Have you ever been con~ricted of any carne, rrusdemeanor, or ~riolation <br />of any municipal ordinance relating to the care or treatment of animals? <br />^ Yes [~No <br />6. Corporation, Partnership, Other Oxa n17ation: <br />A. Is the corporation, partnership, or other organization organized under <br />Minnesota lavT? ^ 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 ace). <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 following <br />information: ~ct, -~'~ ~ ~ y '~ ~-.T ~ ~- Ce. -'~, a '(~v ,n, -- ~ -~~' CI~fi C.l-~R,~, <br />Name Phone # <br />Address <br />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 ~ ~/1 ~l7 a' ` 3 ~ ~ ~- . ~ ~ ~~ t~- ~ ~ ~'~ ~ N <br />ss~.~ 3 0 <br />
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