Zoning 1989(Check one or both):
im
ty
ZONING - NOTIFICATION OF INTENT
a Family Foster Home
❑ Family Day Care Home
Munici ality or Political Sub -Division)
La (13 / d (WyzI u l -U 4 tZ_
Street Address) J
CAJ y
State
FROM: Nekton Inc.
County Welfare Department or Voluntary Agency
276 North Snelling Avenue
Street Address
Zip
St. Paul Minnesota 55104
City (State) (Zip)
SENT BY: CAVlr\ Family Network
Name Department Division
APPLICANT: Ld " g" e / <
Name
P &Z
Street Address)
--7—city)��——State S y 3 Zip
FOSTER CARE
rNumber of Natural Children under 18 in Home: (Circle Number) 1 2 3 4 5
Number of Foster Children included in License: (Circle Number) 0@ 2 3 4 5 6 7
DAY CARE
rummber of Natural Preschool Children in Home: (Circle Number) 0 1 2 3 4 5
ber of Day Care Children included in License: (Circle Number) 0 1 2 3 4 5
DATE OF NOTIFICATION:
Day) (Year