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City of Mounds View, MN <br />Develo meat A iication <br />Present Use of Property <br />O Undeveloped/Vacant r' <br />• Single Family Dwelling <br />• Duplex/Two Family Dwelling <br />• Business/Commercial Establishment ❑ • Multi - family Dwelling <br />Other (explain) Industrial Establishment <br />Property Classii cation 0 Abstract <br />Description of Proposal <br />Torrens <br />to two lots. One with <br />BY MY (OUR) SIGNATURE ON THIS APPLICATION, I HEREBY DECLARE THAT, TO THE BEST OF MY <br />KNOWLEDGE, THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br />Signature of Applicant <br />Name of Applicant (typed/printed) <br />Signature of Property Owner <br />Name of Property Owner (typed/printed) <br />Address of Owner <br />Phone Number of Owner <br />MIA NE <br />CY PETERSON <br />ETERSON - <br />(7) Al 444_A4AP <br />FOR OFFICE TISE ONLY <br />Date of Submittal y _Cl <br />Date of Acceptance <br />s Assigned to: <br />Planning Case No. <br />`% — 9 b0iay Limit 120 -dav limit <br />Fees Paid: <br />Application: do <br />Park Dedication: <br />Deposits: <br />Other: <br />Total: <br />N:I DATA1GROUPS1COMDEVtFOR.titStDEv, .PP.FOR <br />Account g <br />11)7 <br />Caeck # <br />Receipt 4 <br />L9$ <br />