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� <br />�+�N .�.�; <br />� <br />�•,;� °;;. j�,"� . <br />\ r/ l!l'�':�; I j:%`�;; <br />.� <br />a <br />N !J:� .� <br />�A ::�':.� .^<< <br />�n ' <br />,• <br />�'YS 0 (�ftfltfl�Q <br />AppGcani I�fo�ation <br />Name ot'Applicant <br />.4dttress <br />i` <br />COl 1 DE`V�IJ�P11��Ii° DE��$'I�l�$dT <br />D��LO�IV��ii' ��.PPLIC'A'I'TON <br />2401 Hi,�hway i0, IVlounds Vie�uv MN 53112 <br />61 Z-71 �'-�020 <br />612-7�4�3452 - F�X <br />Pfease "�ype ot� pr9at Tnfo�xnaiio�a - Goc�plete ffioth Sides of i°bis F'orm <br />D a r� (� � �� � <br />� e7S C� �. T T' �'� <br />-�� g Y ; � �-J m � <br />' r'�) ) � a <br />Inier�st in �rop�riy (check appropnate box) <br />� C?wner of Property <br />❑ Lzssee, Operator, Manager <br />❑ Other (explain) — <br />Te(ephone ���' % �b'S%% � <br />Fax <br />� Can�acY for Deed Owner <br />Q Agreement tv Pt�chas� <br />r�ppGcants �ust provitfe evidence of intea°c,yt in Propei°ty at the ti,me af appGcatio�, and if yo�a are �ot tde ow�es° of ihe <br />P�'�Pe�3', Y�� ��sB prnvide a feeter of per�issioet ft°o� Yhc ow�e¢° n�g co�s��f to 2he f�ling o( tpti� appiicalloo. 'ihe <br />properry a�ner ffiust sign tlais appiicatioo for iC to be accepied, <br />Property IBe9cription/Proposal <br />Address or GG�neral Location <br />Legal Desc�igtian <br />Property Identificaeio� � (PIN �) <br /># of Acres <br />Cucrene Zoning <br />� <br />�-� ��-i �',1t-�'-� <br />Lv T�� � l 2 �/! �'uJdOcF d'�QC� �� <br />':� <br />� <br />Type of Applic�tion <br />Q Compreheusive Plan Amendmez�t <br />� Rezoning <br />Q Major Snbdivisioa <br />Q �Vfinor Subdivision <br />� P!anned Uni[ pevelop�n�nt (PL'D} <br />� PUD �nendment <br />� Conditiona! Use Pzrmit <br />� Variance <br />Q Code ApPeal <br />� Develop Revie�v/Site Plan <br />a Wecland Alteratioa Pennie <br />� Wedand $t�#%;rr P�rtnie <br />a Floodpiain Pezmic <br />a Other <br />S25Q <br />�250/acre; �irt �Z50 max S ] SOa <br />�%SQ + �Z50 deposie� <br />�200 <br />Reier to rezaning tees <br />�350 <br />R-[, R-2 57�; al! athers $250 <br />R- l, R-2 � l Ofl a1I others �25d <br />�100 <br />� 12j/acre: mi� � i 2� max �750 <br />Ra I, R-2 � 1�0; all others �200 <br />R- �. R-2 �25; aII at�ers � 100 <br />5200 <br />"Deposics shal] be naid to cover all casts ot pub(ic notices, materials and statY'or consulGant tiane s�penc i� th� revie�v, <br />researca or preparation oY matcrials �sso�;iated wich this application_ The applic�t snall b� resnonsible tor a1I re:LSOn�ble <br />incurrNa cas[s in c�ccess of [he ;stitia! cieposit aanotznt. ,�nv portion of the deoosit not sprnt or encumbered shalj b� refunded <br />to the applicane witlun thinv (;0) dnys aii�r Gonsideration of thr application is compfeteci <br />P9e:�e cocnpiei� ehe revers� siefe of thi� applieation, <br />