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a�i' �� <br />?1:.11���is ��� <br />� <br />p �+�,�7 <br />•� ��.� , <br />rn���'� ''Partfletsti�4� <br />C�2 D�+ �L�P I�'7.' ��+ � � � - � <br />I)E�IJOP�NT APPIJICA'�O� � <br />2401 I�iighway 10, Mour�ds �Ii�w I�rIN 55112 <br />Pte�se �'ype or Pr�� In�oa°�atiora - C'ornp�ete �oih Sides of `I'bis F'oe°r� <br />612-71 i-4020 <br />612-7�4-3462 - FAX <br />Applicant Informafeo�s <br />Name of Appiicaaat �%�w t�1 c� � (�8 � �% l�e � /G .�u�'o0 [.�;' Telephone (Q�"`/ • lp�q • � <br />Address 2i6 D a ��s e�d� � Fax <br />�� �iP�f !� /`7/� `°�i / / c� <br />�t��st �n Proper�y (check appropr�ate box) <br />Owner of°Property ❑ Con�act for Deed Owner <br />� Lessee, Operator, Managcr . e7 A�eement to Purchas� <br />o Other (explain) _ <br />.,�plic�s��� �ust provgde evideace of snterest io p�aperr@ty. �t Qhe tdme af agplECation, anci if° �ou a�e �aat tl�e o�nea° of tiae <br />prope�°°ty, yos� �easi �rovade a le8ter of permiss°soe� from the ownee° givas�g coeasee�t io the �Itng of thea applicatio�. �'he <br />�ll'O(9B1`t3' OW[1CP° It4�d3$ 31�IA �IlA3 :1�7j1I9C1t90&! �O� I� t0 U0 RCCCii$B�e � � <br />Pe°opea°�y I2escrsgiio�roposal <br />Address or General Location <br />Lega! Description <br />'" _ . . . . J:` . r.� � > � . <br />� • ,; <br />�_ � ., �� <br />Property Identification # (PIN #) ° • � 3 � /� � D oO 2 <br /># ofAcres �. � /����5 <br />Current Zarvng � - ` p <br />Type of Applic�tion <br />o Comprehensive Plan Amendmenc <br />o Rezoning <br />❑ Major Subdivision � <br />o , Minor Subdivision <br />o Planned Unit �eveiapment (I'LTL)) <br />❑ PUD Amendment <br />� ConditionaUlnterim Us� Permit <br />�$ Variance <br />� . Code Appeai <br />� Develop Review/Site Plan <br />o VVetland Alt�ration Fermit <br />� 'Wetland Bu�er Permit <br />❑ Floodplain Pemut <br />o Other <br />$250 <br />$2Sfl/acre; min $250 max $1500 <br />�250 + $250 de�osit* <br />$zao <br />Refer to rezoning fees <br />$35Q <br />R� I, R-2 $7S; alf othees $250 <br />R-1, R-2 � 1 fl� ali others $250 <br />$100 <br />$125/acra; mirt $125 max �750 <br />it4t, R-2 $150; all others �200 <br />R-1,12-� $2S; �11 others $100 <br />5240 <br />*Deposits shall be paid to cover at1 costs of public r�otices, materials and sta� or consuitant time spent in 4he review, 's <br />research ar preparation of materials flssociated wsth this application. The applicant shall be responsible for sIl reasonable = <br />incuned costs in excess of the initial deposit amount. Any poriion of th� deposit not sgent or encumbered shall be refundad <br />to the apgiicant within ihirCy (30) days after consideration of the appiication is completed. <br />Please �m�r�pBet� 4he �°����°�� sid� af this applic�tione <br />i.. <br />� <br />