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❑ Plat —Sketch Plan <br />El Administrative Plat <br />El Plat — Preliminary Plat <br />Q Site Plan Review <br />Conditional Use Permit <br />El Zoning Amendment <br />[] Dwelling Moving Permit <br />Ei Non -Traditional Animal License <br />D Interim Use Permit <br />fl Home Occupation Permit <br />[] environmental Permit <br />[� Beekeeping license <br />Applicant Contact Information <br />Please note: All official communication will be routed through thi <br />Name: <br />Matthew Chamberlain <br />street Address: <br />— <br />4925 179th Ln NW <br />1- <br />City, State, ZIP: <br />Ramsey, MN 55303 <br />Home Phone: <br />(763) 213-8114 <br />Work Phone: <br />Email: <br />chambo0331 @I11Sf1.00171 <br />Fax Number: <br />Name of Business (if <br />applicable): <br />Business Address (if applicable) <br />Business City, State, ZIP <br />Business Phone: <br />Business Fax: <br />