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_ �_z__ � i <br />_ _ _ . _ _ ; _> _ , � :.� ._ _ <br />._�<:�. _ _ _ — - - - - -- <br />:. _ _ <br />. ---- - --- - -- --. _.-- - -- ---�---- . � -- - � <br />i;u'ii `i� �:�' <br />l J� I Jj:� �ri4: <br />A <br />�° �.`•I:�':'�t:r <br />�,� . .. <br />ti <br />,('ri f� � ParMeYS��Q <br />AppGcant Information <br />Name of Applicant <br />Address <br />COlV11l�IUNTTY DEVELOPMENT DEPARTIi�EN'I' <br />DEVELOPIi�IENT APPLICATION <br />2401 Highway 10, Mounds View MN 55112 <br />612-717-4020 <br />612-784-3462 - FAX <br />Please Type or Print Information - Complete Both Sides of This Form <br />�-(� 763 -�7��--5�(�,2 <br />�1� � L. � � ,� s e � <br />-f''I <br />7 �l"1 �l � (�c�V �C��(J �-� <br />Nt � v�I � U 0�-ti' iM. �..1 <br />SSI l 2. <br />Inte�st in Property (check appropriate box) <br />� Owner of Property <br />❑ Lessee, Operator, Manager <br />❑ Other (explain) <br />Telephone � ' � �3 �� � L �`3 �� �'' � <br />Fax <br />❑ Conh-act for Deed Owner <br />❑ Agreement to Purchase <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 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 -�y �1 q ` �r <br />Address or General Location /��-1 G``Clv � ��ivi,n ��� ILl�1 �-�t''� S 11 t�.'ti s� �� Z <br />Legal Description � Ll-- � 1 C� � t l �7� , S�� N(� L� ��� I:IV C� �.S <br />Property Ident�cation # (PIN #) '��,�QL � f1 �J �(�,�5 ��/ �.O�+N ��� ��1 I N �-' ' <br />—r � <br /># of Acres ��.C� �� �l� yU � �! � .S � � !� � E,' �`�( <br />Current Zoning � S`�� .� ll��.-�C��' ca � � Y 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 />❑ Variance <br />❑ Code Appeal <br />a Develop Review/Site Plan <br />❑ Wetland Alteration Pernut <br />❑ Wetland 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-1, R-2 $75; all others $250 <br />R-1, R-2 $100 all others $250 <br />$100 <br />$125/acre; min $125 max $750 <br />R-1, R-2 $I50; all o[hers $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 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 complcte the reversc side of this application. `►' ��� �� <br />�f���7 <br />