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ry��l if''.i�..'T'� <br />; �,s� �,::; ;,:; <br />`�i:.�;��: ��. <br />.� <br />"•,, �i(.:°; :�?<< <br />;o��� ° Parrner6���y <br />H <br />COMIVIU1�iITY 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 of Applicant � � � � ��: '.� <br />( I <br />Address ���'� � �4(l i�' C �ZIL � <br />r" Gl•� 6,G�f c�J �N i1�� <br />�erest in Property (check appropriate box) <br />Owner of Properfy <br />o Lessee, Operator, Manager <br />❑ Other (explain) <br />_ 612-717-4020 <br />612-784-3462 - FAX <br />Telephone �%[ �—1 r 0 �L' .` �✓:j =�� �% <br />Fax -- -- <br />o Contract for Deed Owner <br />❑ Agreement to Purchase <br />Applicants must provide evidence of intere�t 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 the owner giving consent to the �ling of this application. The <br />property owner must sign this application for it to be accepted. <br />Property Description/Proposal <br />Address or General Location <br />Legal Description <br />Property Identification # (PIN #) <br /># of Acres <br />Cunrent Zoning <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />❑ Rezoning <br />❑ Major Subdivision <br />❑ Minor Subdivision <br />❑ Planned Unit Development (PUD) <br />o PUD Amendment <br />t� <br />❑ Conditional Use Pernut <br />y''�•, Variance <br />❑ � Code Appeal <br />❑ Develop Review/Site Plan <br />o Wetland Alteration Pemut <br />❑ Wedand Buffer Permit <br />❑ Floodplain Pernut <br />❑ Other <br />$250 <br />$250/acre; min $250 max $1500 <br />$250 + $250 deposit* <br />$200 <br />Refer to rezoning fees <br />$350 <br />R- I, R- all others $250 <br />R-1, R- $100� 11 others $250 <br />$l00 <br />$125/acre; min $125 max $750 <br />R-1, R-2 $150; all others $200 <br />R-1, R-2 $25; all others $100 <br />$200 <br />*Deposits shall be paid to cover all costs of public notices, materials and staff or consultant tune 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 annount. Any portion of the deposit not spent or encumbered shall be refunded <br />to the applicant within tkurty (30) days after consideration of the application is completed. <br />Please complete the revetrse side of this application. <br />