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� <br /> ��� Pu9`'°s FFICE USE ONLY <br /> °N� MINNESOTA DEPARTMENT OF PUBLIC SAFETY <br /> e � <br /> ��" ='�a DRIVER AND VEHICLE SERVICES <br /> ': ,'' 445 Minnesota Street EA�ER NUMBER: <br /> ``'�' o,MM„5°� Saint Paul, MN 55101-5186 ATE RECEIVED: <br /> --� Phone: (651)296-2977 Fax: (651)297-1480 NITIALS: <br /> Web:dvs.dps.mn.gov Email: DVS.DealerQuestion@state.mn.us <br /> Minnesota Vehicle Dealer License -Zoning Verification <br /> The Zoning Official for the jurisdiction in which the dealership resides must complete form. <br /> Zoning District:�-z Lp���S�otzr.�'C3�szN�55 -�-�r►za�T <br /> This form is for (check one): I�Primary Location r Additional Location (Attach a separate Commercial <br /> Checklist Form (PS2410) for each location) <br /> DEALER NAME �IO2 T� S�tvtZ..�.� ("�I`�R-S1Jt� ��C� <br /> Street �ZZZ N o ZT<+- S l�c�Gz�F_ �Z-s v� <br /> City VJ A`(z•�-rA- StateMl� Zip .SS3�1 County F}�NN,�"/✓ <br /> Type of Dealer's License (Check One) <br /> ❑NEW ❑USED �LESSOR �D.S.B. �WHOLESALER �BROKER �AUCTIONEER �SALVAGE POOL ❑UMITED USE VEHKLE <br /> Please Check Appropriate Statement: <br /> �,lT'his dealership is permitted use within the above zoning district for the type of business indicated <br /> y�above and there are no zoning complaints or enforcement actions pending at this time. <br /> This dealership is permitted conditional use within the above zoning district for the type of business <br /> � indicated above and there are no zoning complaints or enforcement actions pending at this time <br /> (Must attach a copy of the conditional use permit). <br /> Printed Name of Zoning Authority: M�ll�� � GA�-� ,�-5�-�; �� t��lN�s?7��� <br /> Gt�t od"D�No��NI� <br /> Zoning Authority Phone Number: ��L -2`�q-�j(oZz— <br /> Subscribed and sworn to before me this <br /> � I � day of �U� 20^I <br /> (Signature of Zoning Authority) NOTARY PUBLIC <br /> COUNTY: l��/ v� <br /> MY COMISSION EXPIRES: I - 3 I - I <br /> �Cf�'�"'t"r;•. <br /> n'"�., MONICAA.FADNESS <br /> �� ` NOTARY PUBLIC-MINNESOTA <br /> <'��'�` �'�My Commission Ex ires Jan.31 2017 <br /> "•;e��;u,,, P � <br /> PS2421-04(02/12) ' ,,.;Y<;�'� <br />