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trrr <br />Partwat 1∎\.��° <br />Applicant Information <br />Name of Applicant <br />Address =�(✓ i `aC� <br />Nd <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 />0 <br />Interest in Property (check appropriate box) <br />X Owner of Property <br />• Lessee, Operator, Manager <br />• Other (explain) <br />Telephone <br />Fax <br />L�a�33o�5� <br />c �• <br />tom! - `1`iS -(, °, Ne <br />4 Contract for Deed Owner <br />0 Agreement to Purchase <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 filing of this application. The <br />property owner must sign this application for it to he accepted. <br />Property Description/Proposal <br />Address or C-enerral Location <br />Legal Description <br />Property Identification # (PIN #) <br /># of Acres <br />Current Zoning <br />Type of Application <br />• Comprehensive Plan Amendment <br />• Rezoning <br />▪ Major Subdivision <br />• Minor Subdivision <br />• Planned Unit Development (PUD) <br />a PUD Amendment <br />Conditional Use Permit <br />O Variance <br />O Code Appeal <br />o Develop Review /Site Plan <br />• Wetland Alteration Permit <br />a Wetland Buffer Permit <br />O Floodplain Permit <br />• Other <br />S250 <br />S250/acre; min S250 max 51500 <br />S2.50 + S250 deposit* <br />S200 <br />Refer to rezoning fees <br />S350 <br />R -1, R -2 S75; all others 5250 <br />R -1, R -2 S100 all others 5250 <br />5100 <br />S 125 /acre; thin 5125 max 5750 <br />R-1, R -2 5150; all others 5200 <br />R -1, R -2 525; all others 5 100 <br />5200 <br />*Deposits shall be paid to cover all costs of public notices. materials and stall or 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 />