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�t��v �ro �t { �� ��� . — i ry,. f�g-h?� ���, <br />� � z � �� � i,�''� <br />� E�e ti��:� r�.� o.:. r <br />b�, 2 <br />Lr8 I�u' K�_.','u- <br />: )r�j�:t(:i S:�v <br />.. J�.i:: <br />.� <br />p°�,, �3I;?,;�l;�r <br />fo�R�Jt ° Parrne'����a <br />� � �t ~��'�%����{�/e, -��<;,�.,�c�t.. <br />� � �� .Fid� ( L'iA <br />�.�l���l�'�'� ��.��.�D�°l�'Y�.I��' ��PE��'�kil�'� <br />���LOP1�I�dT A�P]LgCA�'][�T� <br />2401 Highway 10, Mounds �iew MN 55112 <br />�'I�as� �'ype �r Pcint B�afo�aan�tiou� - Co�p�lete �ofh Si�es mf'g'inis lE�r�e <br />612�717�4020 <br />612-7�4-3462 - FAX <br />AppGcant Infoe�nation /" l <br />Name ofApplicant __����-�c2.;' %� � S'��' �S �� TelephoneL� � Z-I ��7 — 7 2. 1� <br />Address � ° <br />S y�{.S �J ac ks'o � r� v-e_�p�'�i� 3� f Fax <br />✓� U t,� v� �.! I�. �J , �'I /U �.�'/ / 2 <br />, <br />In�terest in Property (check appropriate box) <br />� Owner of Property ❑ Contract for Deed Owner <br />o Lessee, Operator, Manager p Agreement to Purchase <br />❑ Other (explain) <br />Applicants mast 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 the 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 />Address or C,e:neral Location <br />Legal Description <br />Property Identification # (PIN #) <br /># of Acres <br />CtuTent Zoning <br />Zy�fz �9�� �� <br />���t 3 . .�1�� � <br />Type of Application <br />❑ Comprehensive Plan Amendment <br />❑ Rezoning <br />❑ Major Subdivision <br />❑ Minor Subdivision <br />❑ Planned Unit Development (PUD) <br />❑ PUD Amendment <br />❑ Conditional Use Permit <br />j�'' Vaniance <br />❑ Code Appeal <br />❑ Develop Review/Site Plan <br />o Wefland Alteration Permit <br />❑ Wetland Buffer Pernut <br />❑ Floodplain Pecmit <br />❑ OPher <br />vtd P�' /"7`��L � ���'� <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- I, R-2 $100 all others $250 <br />$100 . <br />$ I 25/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 time spent in the review, <br />research or preparation of materials associated with this application. The appIicant shall be responsible for all reasonable <br />incu�red 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) daps after consideration of the application is completed, <br />Please complete the reverse side of this appiication. /, � � <br />. 3 `��8�' . <br />