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��� o� <br />�u�ua <br />-a ' ♦ <br />R' I � � ��1 <br />.�� <br />S <br />d'r��,s - Partne'�Sr�� <br />Appiicant Informa#ion <br />Name of Applicant rr� ouwn r✓, E�+� A"" "'?'-- k�?v ,� �-,- Telephone `?G3 �- �''�'.� -��s"I <br />2 S a'� �� / U /✓� FdX '� `'�D C� c7 5"3 <br />�'d oyr�✓os �c � m w S"5-1 � Z - <br />COMMUNITY DEVELOPMENT DEPARTMENT - <br />PLANNING APPLICATION <br />2401 County Road 10, Mounds View, MN 55112 <br />(7fi3} 717-4020 <br />Fax (65i) 765-].660 <br />Please Type ar Print Informatian - Complete Both Sides of 7his Form <br />Address <br />Interest in Property (check appropriate box) <br />❑ �wner of Property <br />❑ Lessee, Operator, Manager <br />❑ Other {explain) <br />❑ Contract for Deed Owner <br />� Agreement to Purchase <br />Applicants nzust provide evidence of interest in property at the time of application, and if you are not <br />the owner of the property, you must provide a letter of permission from the owner giving consent to `--�- <br />the filing af this application. The property owner must sign #his application for it to be accepted. <br />Property Description/Proposal <br />Address or General Lo�ation <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 />0 planned Unit Development (PUD} <br />O PUD Amendment <br />� Conditional/Interim Use Permit <br />variance <br />❑ Code Appeal <br />,� Develop Review/Site Plan <br />0 Wetland Alteration Permit <br />O Wetland Buffer Permit <br />❑ Floodplain Permit <br />� Other <br />LTY ��'� � a- C7�1 /� � �• <br />Z�zr �N �o �v�, - <br />i 6 / <br />$250 <br />$Z50/acre {Min $250 max $1500) <br />$250/acre (mfn. $500) <br />$200 <br />$500 plus $500/aere <br />$350 <br />R-1, R-2 $1Q0; all others $3�0 <br />R-1, R-2 $100 all athers $300 <br />�iao <br />$125/acre; min $125 max $750 <br />R-1, R-2 $150; all others $200 <br />R-i, R-2 $z5; all others $100 <br />$200 <br />A deposit may be required to cover costs of public rto�ces, materlals and staff or consultant tlme spent in the review, research or <br />preparatlon of materials associated with thls appUcatlon. The applicant shall be responslble for all reasonable Incurred costs fn excess of <br />• the Inftial deposit amount. Any portion of the deposit not spent or encumbered shall be refunded to the appUcant within 30 days after <br />consEderatlon of the applicatlon is mmpleted. <br />