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.1:L7r 441 <br />LJ ag'!IV <br />°Partnea���@ <br />Applicant Information <br />Name of Applicant <br />Address <br />CONDI-UNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATION <br />2,401 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 />Adolfson & Peterson Construction <br />...... ........ ....................... <br />6701 West 23rd Street <br />Minneapolis, Minnesota 55426 <br />Telephone ( 612) 544 -1561 <br />Fax (612) 525 -2333 <br />Interest in Property (check appropriate. box) <br />O Owner of Property -- Cl _' • - Contract for Deed Owner _. <br />O Lessee, Operator, Manager ' a - ' Agreement to Purchase <br />gi Other(explain) esian Build Contractor for ansions and Renovations <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 fling 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 . 2400 County Road J, Mounds View <br />Legal Description -: . N 1 /2 , NW 1/4 of Section 5, T30, R23 <br />Property Identification # (PIN #) . 05302322005 �' ----- _ _ <br />#offAcres 23.933 . - . <br />Current Zoning Planned Unit Development <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />• Rezoning <br />o Major Subdivision <br />O Minor Subdivision <br />▪ Planned Unit Development (PUD) <br />a PUD Amendment <br />O Conditional Use Permit <br />▪ Variance <br />Code Appeal <br />Develop Review /Site PIan <br />Wetland Alteration Permit <br />t] Wetland Buffer Permit <br />a Floodpiain Permit <br />n Other <br />5250 <br />3250 /acre; min S250 max S1500 <br />6250 + S250 deposit* <br />S200 <br />Refer to rezoning fees <br />$350 <br />R -1, R -2 $75; all others $250 <br />R°1, R -2 3100 all others 5250 <br />3100 <br />S125/acre; min S125 max S750 <br />R-1, R -2 S150; all others 5200 <br />R -I, R-.2 S25; all others $100 <br />S200 <br />*Deposits shall be paid to cover all costs of public notices, materials and stair or consultant time spent in the 'review, <br />iesearch or preparation of materials associated with this application. The applicant shah 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 />