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t ---- � —_- --- - -_ �._. <br />���'�`�7 �:� <br />�rl7:�r • � <br />���l��J;i;i i! �%t <br />�0 <br />� 1.:.x<ii..j <br />°,o !i�r::>;4U� <br />r <br />♦ <br />Bn�'u ° PartnerS��Q <br />_ � -- <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATION <br />2401 Highway 10, Mounds View MN 55112 <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information � <br />Name ofApplicant � � ���1� �' �y^y�J <br />Address ��IO I f� 7 � �_ <br />!/1/1 b r,�.aL� S us� r.J f ry1�` <br />_ ���� a <br />Interest in Property (check appropriate box) <br />� Owner of Properly <br />❑ Lessee, Operator, Manager <br />❑ Other (explain) _ <br />612-717-4020 <br />612-784-3462 - FAX <br />Telephone ;� �c� ^ 7 � 7 � ��'� <br />Fax _ % �o� ` � 8`� -3`/�� <br />❑ Contract for Deed Owner <br />o Agreement to Purc�ase <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 tl�e 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 />6 Address or General Location <br />Legal Description <br />Property Ident�cation # (PIN #) <br /># of Acres. <br />Current Zoning <br />�n� <br />'S G�� <br />v c,��r�� l� ) �1 � <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />o Rezoning <br />❑ Major Subdivision <br />o Minor Subdivision <br />� Planned Unit Development (PUD) <br />� PUD Amendment <br />�( Conditional Use Pernnit <br />❑ Variance <br />p Code Appeal <br />o Develop Review/Site Plan <br />❑ Wetland Alteration Pemut <br />❑ We[land Buffer Permit <br />❑ Floodplain Pernut <br />❑ Other <br />$250 <br />$250/acre; min $250 max $1 S00 <br />$250 + $250 deposit* <br />$200 <br />Refer to rezoning fees <br />$350 <br />R-1, R-2 $75; all oth s$ 5 <br />R-1, R-2 $100 all others $2 <br />$]00 <br />$125/acre; min $125 max $750 <br />R-1, R-2 $150; all others $200 <br />R- I, R-2 $25; all others $100 <br />$200 <br />� �� <br />*Deposits shall be paid to cover all costs of public notices, materials and staff or consultant time spent in the review, <br />research or preparation of materials associated with this application. The applicant shall be responsible for all reasonable <br />incurred costs in excess of the initial deposit amount. Any portion of the deposit not spent or encumbered shall be refunded <br />to the applicant within thirty (30) days after consideration of the application is completed. . <br />Please complete the reverse side of this application. <br />