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� <br />• �. <br />�� � � <br />)i ��;��;iC`;;; COMMUNITY DEVELOPMENT DEPARTMENT <br />-� D�VELOPMENT APPLICATIOP <br />P.�, i:[:=�:;:;; 2401 Highway 10, Mounds View MN 55112 <br />,�'�hj= ° PartneYSt��Q� E) I Z—% 1%-4020 <br />612-784-3462 - FAX <br />Please Type or Print Ipformation - Complete Both Sides of This Form <br />Applicant Information /� <br />Name of Applicant __ (S iC � �" 0 i� �/ �- �,_ � z ►a m� rN Telephone �/ Z - % �' (� � (� � [U � <br />Address ig � (i Y1� �',� rax <br />��i:.�� ��o v E � w rv ��e � <br />%�l o U nl ��� v I� �J w1 n� �- S� 1/ z- <br />L►terest in Property (check appropriate box) <br />� Owner of Property ❑ Contract for Deed Owner <br />❑ Lessee, Operator, Manager ❑ Agreement to Purchase <br />❑ Other (explain) <br />Applicants must provide evideace of intere9t in property at the time of application, and if you are not the owner of the <br />property, you must provide a Ietter of permission from tlie owner giving consent to the filing of this application. The <br />property owner must sign this application for it to be accepteJ. <br />Property Description/Proposal /' <br />Address or General Location ��/� t� 11— �Q U L"C, l� GU k1 R b� rn c7 t�' io � U/ C�,� <br />Legal Description �� IeTI-1 '�- e,) f�k I IQ 1(! l� �i h i0 J T�/r) n� LO 7'.,j �LL'� .Z, <br />Property Ident�cation # (PIN #) <br /># of Acres <br />Cunrent Zoning <br />0 6 � o L�� � � c2c� `I S"" Z. � z I le C� Y O� <br />I�� <br />� CS t .v �''VVT 11i4L <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />❑ Rezoning <br />o Major Subdivision <br />❑ Minor Subdivision <br />t7 Planned Unit Development (PUD) <br />❑ PUD Amendment <br />❑ Conditional Use Permit <br />❑ Variance <br />❑ Code Appeal <br />❑ Develop Review/Site Plan <br />❑ Wetland Alteration Permit <br />❑ Wetland Buffer Permit <br />❑ Floodplain Permit <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-1, R-2 $75; all others $250 <br />R- , 2 $100 Il others $250 <br />$10 <br />$125/acre; min $125 max $750 <br />R-1, R-2 $150; all others $200 <br />R-1, R-2 $25; all others $] 00 <br />$200 <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 wi[h this application. The applicant shall be responsible for all reasonabte <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 />