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City of Falcon Heights <br />Planning Application <br />Action Requested By: r ~' <br />Name of Property Owner 1~4'~ /~t1(; ~~ 1 lti~+~ tl~r!1 Vii/ <br />Phone (h) ~S"1- ~~ 9 - ~p~ ~.~~ (w) <br />Address of Property Owner ~I'=~~0 ~~, ~~~ ~f ~~~f~'~~ S <br />Name of Applicant (if different) f' ~~w~ ~WA,~ <br />Address SUS f~l•~-%,~~i r~ 3e~vtn . r'~j~ ,55yLr Phone ~Sl-i,~q-(v31~ <br />Property Involved: <br />Address _ 13'{ 7 ~N',C~~l tf~/ AVZ IIV. <br />Lega! Description _ f~ Ral ~~;~yf ; ~ 9b.~ ~ 1'-~ <br />Property Identification Number (PIN) (s =~9.2 ~ ~ ~y - ~ ~3~ <br />Present Use of Property (check one): <br />^ Single Family Dwelling ~ Business/Commercial <br />^ Duplex/Two Family Dwelling ^ Government/Institutional <br />. ^ Multi Family Complex ^ Vacant Land <br />Action Requested (NON-REFUNDABLE): <br />Variance ($100.00) ^ Lot Split ($250.00) <br />^ Conditional Use Permit ($165.00) ^ Site Plan Review ($100.00) <br />^ Rezoning ($500.00) ^ Other (Please Specify) <br />Brief Summary of Request (applicant may submit letter to Planning Commission with <br />details of request): <br />~t(e ati'~ V'~~~ti~str~1~ ~. Uanri u,ri crr ~ ~'~~it~ ~ Set b~,i-~ oY- ~L.E ~~sr ~; ~e c~ ~ <br /> <br />`~~~' L b'~ ~;,iMwm ~'esf,^bi~,[e L~,`h-u,~~ a~ ~~ 5; ife a~' ll~ b~~ld~hq , <br />l certify that all statements on this application are true and correc . <br />1 ~~/ ~~~ <br />Signature of Property Owner (required) Signature of Applicant (if applicable) <br />~~a <br />S:IFORMS1Zoning and Building FormsIPLANNING APPLICATION.doc 3/29/2005 <br />