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City of Oak Park Heights
14168 Oak Park Blvd.
Box 2007
Oak Park Heights,MN 55082
Phone (651) 439-4439 —Fax(651)439-0574
www.cityofoakparkheights.com
-Y(2016 k'it 0.1 — U-P da ° '
HOME OCCUPATION PERMIT APPLICATION
Applicant: cl CL/kPf t OSA) Phone# &' �-f — 1
Street Address: 1 \ 0 1 t 1 - N
City D A Zip ( ,Q Email: bLk2c, OC C1 ( IY sn C ov)
Pursuant to MN Statute 270.072 Tax Clearance; Issuance of Licenses,the licensing
authority is required to provide the Minnesota Commissioner of Revenue your Minnesota
business tax identification number and social security number of each license applicant.
Please provide the following information as it applies to your home occupation: '`
Business Name: IMO A t?Q,,� ' �(`t '� 1 I i bacafdC\' �C,\c CF
Minnesota Tax Identification Number: . �J
Federal Tax Identification Number: 1 t.Q- S
Personal Information(Name): k.
Social Security Number: -
For application property:
Street Address: <-lS,t Pfle, (iS CAVE,
City Zip
Legal Description of the property:
Zoning District:
Is the property connected to the City water and sewer system? V -Yes No
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(If additional space is needed to adequately answer the following,please accurately
number and answer the responses on the back of these sheets.)
Describe the home occupation(type of home business)being proposed:
+ tQ AC91.0tt\e2
Describe the character of the existing surrounding property:
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Who is to be employed in proposed occupation?
CA LE. FAIQA)
-eC r;F TAW c - 0 t.c
\ \+CAE-- °Kim
Will any person(s)be employed that does not live at the occupation address listed in this
application? Yes No
In what part of the structure will the occupation be located?
\r COL
2
How many customers will be served at one time?*am u cin
What are the intended days and hours of this occupation?
MCAVAAL *L( 11,01\— . p()1)
What service will this occupation provide?
Is off street parking available? /Yes No
If yes, describe location, capacity and type of surface:
Will there be a need for street parking? V Yes No
If yes,how much space will be needed?
C)Cf ClSqM6i `,- I „ cVv) os nccctccA
3
Will the occupation require the use of an accessory building? Yes VNo
If yes,please justify the need of an accessory building and describe the facility:
Will the home occupation require or volve any equipment not normally found in a
dwelling unit? Yes No
If yes,please describe the equipment:
Will the occupation involve over- he-counter sale of merchandise produced off the
premises? Yes No
If yes,please describe the merchandise to be sold:
How long do you anticipate the occupation be carried on at this address?
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How much of an investment in the premise is required for this occupation?
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If an investment is required, does it include alteration? Interior Exterior
If so,Please describe the required alteration:
Are other governmental licenses or permits required to legally conduct business in this
occupation? ✓Yes No
If yes,please list the licenses and/or permits below:
R,vm1 < (�`(\A1 .i c\( \c c
The City reserves the right upon issuing any home occupation permit to inspect the
premises in which the occupation is being conducted to insure compliance with the
provisions of Zoning Ordinance 401.15.M"Home Occupations."
May the City inspect the premise during the application process? l/ Yes No
If no,please explain:
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Is there any additional information regarding this application that the City should be
aware of concerning the occupation?
By signing this application, I declare that I have read all applicable City Ordinances. I
affirm that all information provided to the City of Oak Park Heights on this application,
or as a part thereof, is true and accurate to the best of my knowledge.
2 i i �l�
Date: \ 1 A_CJ 1!l!/ •
Signature of Applicant
Please Check One: Fee shall be submitted with complete application.
New: Special Home Occupation —Fee: $100
(Ordinances 401.03 &401.15.M)
New: Permitted Home Occupation —Fee: $ 25
(Ordinance 401.15.M)
/Home Occupation Renewal (Annual) —Fee: $ 15
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