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City of Mounds View, MN <br />Develo ment A hcation <br />Present Use of Property <br />❑ Undeveloped/Vacant <br />o Duplex/Two Family Dwelling <br />❑ Business/Commercial Establishment <br />O Other (explain) <br />Property Classification <br />Descrip on of Proposal <br />Single Family Dwelling <br />❑ Multi - family Dwelling <br />O Industrial Establishment <br />❑ Torrens <br />Pa :e2 <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 />f l (!/v'7 ? L f4 "/ ' 7..// <br />Signature of Applicant <br />Name of Applicant (typed/printed) <br />Signature of Property Owner <br />yi Name of Property Owner (typed/printed) <br />Address of Owner <br />Phone Number of Owner <br />Date of Submittal <br />Date of Acceptance <br />Planning Case No. <br />a cv ! ////7e <br />44 );QRICE USE ONLY <br />531-4111,1$ 60-day Limit <br />Assigned to: <br />12O -day limit <br />Fees Paid: Account # Check # Receipt # <br />Application: l 06.00 p O.3 3 "771r-) <br />Park Dedication: <br />Deposits: <br />Other: <br />Total: <br />N: 1IDATA \GROUPS\COMDEVIFOR4ISIBEVAPP ,FOR <br />1/98 <br />