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;; <br />_ <br />;:I , <br />a�,p sa.� <br />t?3 �1;:�ii .'•::��:�i <br />.� <br />p �'��;,c�; <br />�P €:i.:., • <br />'o��'�t ° PaYMe�t�,ey <br />�� �L �' �`rd.J�S lYAL' l� R L�.[ 1'�d� 19 $ <br />�33EiTEI,O��N'I' APPI.aICE1'�OI� <br />2401 Highway i0, Mounds View MN 55112 <br />612-717-4420 <br />612-784-3462 d FA� <br />I'Iease 'Type or k�rint Inforynatioe� - Co�aple4e �oth Sides of'i'his 1+"oc� <br />Appl°►cant Infot°ffi�iiop <br />Name of Appliaant �� �'�+� �� � I e`�'!'� �� Teleghone 6 ��. 71 7 2.� �d S` <br />Address �T �0 S�i Lo�-i a Cr �c�� �� <br />�o � als ' w �i �/ s",� 1 ! � <br />Ia,tee�si ara ��opex'ty (oheck appropriate box) <br />� Owner of i'roperty �t Contract %r Deed Own�r <br />❑ Lessee, Operator, Manager � Agreemenc to Purch�se <br />o Other (exptain} <br />App�ican�s must �rovide evide�ce of i�terest in prope�t;� at ghe iiffie of appGcatio�, �nd if you ar� �ot t�e o�vaer o�the <br />prapeety9 you muat prov'sde a lettee off pece�ission fro� the o�ser giving consent to the i��� of tiais appiicai�o�. 'Tlte <br />p�peety o�er �us� s'ag� ti�is appiicatiom fo�° ii to t►e accepted. <br />Propevty �eseription/I'roposal <br />Acfdress or General Lacation <br />Legal Descripcion <br />Property Identifiaatian # (PIN #) <br /># of Acees <br />Currene Zoning <br />. <br />� . � ":, : i /� �- <br />Type of Aggtication <br />o Comprehensive Plan Amendment <br />❑ Rezoning <br />a Major Subdivision <br />Q Minor Subdivision <br />❑ p]anned Un,it Development {PUD) <br />❑ pUD Amendment <br />❑ Conditional Use Permit <br />� Variance <br />n Code Appeal <br />� Develop Review/Site Plan <br />❑ Wetland Alteration Permie <br />❑ Weeland Buffer Permit <br />C] Floodptain Pemut <br />� Other <br />$250 <br />$250/acre; min $250 max $1500 <br />$250 + $250 deposit* <br />$200 <br />Refec to rezoning fees <br />$350 <br />R-E, R-2 $75; aEl others $250 <br />R- I, R-2 $100 all others $250 <br />i ao <br />$125/acre; min $ l 25 max �750 <br />R-1, R-2 � 150; all others �200 <br />R- l, R-2 $25; all others $100 <br />�zoo <br />*Deposiis shall be paid to aover all costs of public notices, rt�aterials and stuti or consultant time spent in khe review, <br />' research or preparation of materiaks associated with this appiication. The applicant shali be responsible for all reasonable <br />incutred costs in excess of ih� initial deposit amount. Any portion of the deposit not a-pen[ or encumbered sha11 be refunded <br />to the appticaaat within t[zirl.y (3U} days after consideration of the application is compfeted. <br />�'I�as� coenpi�te ph� revers� sede o� th�� ��pl��ataoo. <br />�: <br />. �� � � <br />