City of Edina Form Center

2. Owner's Name*
3. Phone Number:*
5. Address*
7. Manager's Full Name*
8. Manager's Email Address*
10. Address of Commercial Kennel*
12. Commercial Kennel Phone Number*
14. Provide your Minnesota Tax ID Number. If a Minnesota Tax ID Number is not required, explain. *
15. Provide a Federal Tax ID or Social Security Number. *
17. Type of Business*

    1. Selling
    2. Boarding
    3. Breeding

    1. Showing
    2. Treating
    3. Grooming
19. Zoning Classification Information
    City Code, Chapter 36
20. Zoning Classification*
22. Please provide a detailed plan and description of the premises and structures wherein the kennel is to be operated. *
24. THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. We are requesting this data to determine your eligibility for a license from the City of Edina. Providing the data may disclose information that could cause your application to be denied. You are not legally required to provide the data, however, refusing to supply the data may cause your license to not be processed. Under MS 270.72, the City of Edina is required to provide the Minnesota Department of Revenue your MN Tax ID Number or Social Security Number. This information may be used to deny the issuance, renewal or transfer of your license if you owe the Minnesota Department of Revenue delinquent taxes, penalties, or interest. The Department of Revenue may supply information to the Internal Revenue Service. In addition, this data can be shared by Edina City Staff, the State of Minnesota Driver License Section, Hennepin County Auditor, Bureau of Criminal Apprehension, Hennepin County Warrant Office, Ramsey County Warrant Office, the Minnesota State Auditor and if required by a court order. Applicant’s residence address and telephone number will be considered public data unless you request this information to be private and provide an alternative address and telephone number. Your residence address and telephone number will be considered public data unless you request this information to be private and provide an alternative address and telephone number below. *

    1. I agree.
26. Alternate Address
27. Alternate Phone Number
29. Application Fee
    Application Fee
30. Price
31. Quantity
32. Shipping Cost
34. Taxable
36. I certify all information given above is complete and accurate.

    1. I have read and understand all laws and ordinances pertaining to the operation of the above commercial animal kennel in the City of Edina.
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37. Calculate Totals Proceed to Checkout

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