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City of Falcon Heights <br />Planning Application <br />Action Requested By: <br />Name of Pro erty Owner ~-~~~~ ~~~ ~-- <br />~~'~ ~ ~ ~' <br />P <br />Phone (h) BSI (s~ Le ~2j~°I (w) ~ 9 ~ ~ _ ~ ~f~~ <br />Address of Property Owner /~~~~ /~S ~ (~ 12~~ <br />Name of Applicant (if different) ~-~ <br />Address ~' Phone ~~ <br />Property Involved: <br />Address [ .~ l~~~U <br />Legal Description ~ ~ ~ ~ 1 S <br />~/ <br /> <br />• Property Identification Number (P1N)_ ~~ ~~~ - 02~ ^' .3 2 `- ~~loZ <br />Present Use of ProperEy (check one): <br />Single Family Dwelling <br />^ Duplex/Two Family Dwelling <br />^ Multi-Family Complex <br />Action Requested: NON-REFUNDABLE <br />Variance (~,~~ ~% ~ ~~~ <br />Conditional Use Permit ($165.00) <br />^ Rezoning ($500.00) <br />Brief Summary of Request (applica <br />of request): <br />• p"nct~2 ~~'ane ~ e~re~m~C~'C1? <br />~oE~ herv ~' act ~Ldan <br />^ Business/Commercial <br />^ Government/lnstitutional <br />^ Vacant Land <br />^ Lot Split ($250.00) <br />^ Site Plan Review ($100.00) <br />^ Other (Please specify): <br />nt may submit letter to' Planning Commission with details <br />tvbr~-GCc~ ~~~ ~ .~c.ll c.c/ ~^,~~. (k~ Is s~ov~' <br />~..rLbwt. ~ <br />l certify that all statements on this application are true and correct: <br />Signature of Property Owner required) Signature of A licant if a licabfe <br />PP ( PP ) <br />