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Diffley Rd_1016 #200_Barbershop zoning approvalPage 7 of 8 BUILDING AND ZONING COMPLIANCE To assure that the Barbershop is in compliance with current local building and zoning ordinances, this page must be completed for all Barbershop applications even if the location has been a Barbershop before. BUILDING AND ZONING COMPLIANCE STATEMENT TO BE COMPLETED BY ZONING OFFICIAL, ORIGINAL SIGNATURE REQUIRED I attest that the barbershop located at 1C)16 j_ C� *V- ZCb (Shop Address) as identified in this application, is in compliance with local building and zoning requirements. l Q.r Cit CouMy ofJurisdiction 10 /G��I�itJ� Signature of Zoning Official SO. V-a.01'YtC � Printed Name of Zoning Official CERTIFICATION OF APPLICANT IAV -L Is 0S --ay Title Date (o (- &7 S-6 9(o Telephone I certify that the information included within this application is true and correct. I also certify that this document has not been altered or changed in any manner from the form adopted by the Minnesota Board of Barber Examiners. . y Z�i= 5-23 -Z Signature of Applicant Date Subscribed and sworn before me thisd3 —c mun '166 e , +rav Printed Name of Applicant Notary Seal JULIE ANITA STRID Notary Public-MinmaMa My Conn "Eq*n don 31, 2025V -WV#%AANVVVVVVV1 E My Commission Expires: