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41.7Y c7,,iP2 <br />,p i,., <br />°RrNrr <br />• Par me ssN'R' <br />Applicant Information <br />Name of Applicant <br />Address <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATION <br />2401 Highway 10, Mounds View MN 55112 <br />612- 717 -4020 <br />612 - 784-3462 - FAX <br />Please Type or Print Information - Complete Both Sides of This Form <br />Telephone (0 — <br />P D - Fax <br />3t 1 <br />Interest in Property (check appropriate box) <br />XOwner of Property <br />❑ Lessee, Operator, Manager <br />❑ Contract for Deed Owner <br />❑ Agreement to Purchase <br />O Other (explain) <br />Applicants must provide evidence of interest in property at the time of application, and if you are not the owner of the <br />property, you must provide a letter of permission from the owner giving consent to the tiling of this application. The <br />property owner must sign this application for it to be accepted. . <br />Property Description/Proposal <br />Address or General Location <br />Legal Description <br />Property Identification # (PIN #) <br /># of Acres <br />Current Zoning <br />2. LL 1e t e.) 0 A..)D 1 Z <br />®�- lea 2'3 •t goo <br />Rf <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />❑ Rezoning <br />a Major Subdivision <br />❑ Minor Subdivision <br />❑ Planned Unit Development (PUD) <br />❑ PUD Amendment <br />❑ Conditional Use Permit <br />Variance <br />❑ Code Appeal <br />❑ Develop Review /Site Plan <br />a Wetland Alteration Permit <br />a Wetland Buffer Permit <br />❑ <br />Floodp lain Permit <br />❑ Other <br />S250 <br />S250 /acre; rain $250 max S1500 <br />S250 + S250 deposit* <br />5200 <br />Refer to rezoning fees <br />S350 <br />R -1, R -2 $75; all others $250 <br />R -1, R-2 S100 all others 5250 <br />5100 <br />S125/acre; min S125 max S750 <br />R-1, R -2 S150; all others $200 <br />R -1, R -2 $25; all others $ l00 <br />5200 <br />*Deposits shall be paid to cover all costs of public notices, materials and stator consultant time spent in the review, <br />research or preparation of materials associated with this application. The applicant shall be responsible for all reasonable <br />incurred costs in excess of the initial deposit amount_ Any portion of the deposit not spent or encumbered shall be refunded <br />to the applicant within thirty, (30) days atter consideration of the application is completed <br />Please complete the reverse side of this application. <br />