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A <br />14'1'4 - Pastriee,t`' ' <br />COiVEV€UNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATIr T. <br />2401 Highway 10, Mounds View MN 55 i e m <br />612 -717 -4020 <br />6I2 -784 -3462 - FAX <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information <br />Name of Applicant ' N " 1�'Q N-1 <br />Address <br />072- Telephone <br />l <br />JILT) 70 a a Fax 72-° <br />Sire 11770 <br />75J57 <br />Interest in Property (check appropriate box) <br />o Owner of Property <br />Lessee, Operator, Manager 0 Contract far Deed Owner <br />Agreement to Purchase <br />4 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 filing 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 Identiixcation # (PIN #) <br />4 of Acres <br />Current Zoning <br />5 /1-T71/ -c <br />?u.0 <br />Type of Application <br />• Comprehensive Plan Amendment <br />O Rezoning <br />Major Subdivision <br />a Minor Subdivision <br />o Planned Unit Development (PUD) <br />a PUD Amendment <br />Q Conditional Use Permit <br />• Variance <br />© Code Appeal <br />Q Develop Review /Site Plan <br />O Wetland Alteration Permit <br />Q Wetland Buller Permit <br />a F'Ioodplain Permit <br />• Other <br />5250 <br />5250/acre; min 550 max 31500 <br />3250 ÷ 3250 deposit* <br />3200 <br />Refer to rezoning fees <br />5350 <br />R -1, R -2 375; all others 5250 <br />R-1, R -2 5100 all others 5250 <br />5100 <br />5125 /acre; rain 5125 max 5750 <br />R-1, R -2 5150; ail others 5200 <br />R-1, R -2 525; all others 5100 <br />3200 <br />*Deposits shall be paid to cover all costs of public notices, materials and staffor consultant time spent in the review, <br />research or preparation of materials associated with this appiication. The applicant shall be responsible for all reasonable <br />incurred costs in excess of the initial deposit amount. Arty portion of the deposit not spent or encumbered shall be refunded <br />to the applicant within thirty (30) days atter consideration oldie application is completed. <br />Please complete the reverse side of this application, <br />