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APR 15 2016 <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />® S i�Il�N� PLANNING APPLICATION <br />X401 County Road 10, Mounds View, MN 55112 <br />(763) 717-4020 * Fax (763) 717-4019 <br />permfts@cl.mounds-v1ew.mn.us <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information <br />Name of Applicant 4'._ �_ Work <br />Address ZVt' LN NZS' Clty i/.v'nr <br />Home # Cell # 6/2 - 3S-6 - _2KV'r Fax #_ <br />E-mail /✓?cvk/awt LOMB+. coM <br />Interest in Property/ (check appropriate box) <br />El Owner of Property <br />El Agreement to Purchase <br /># W7-791 -1?94 <br />State MW zip rr yy9 <br />El contract for Deed Owner ❑Lessee, Operator, Manager <br />216ther r6n)c ` to%fla ' <br />App/icantsmustprovide evidence ofinterestin properiyatthe time of application, and ifyon are <br />not the owner of the property, you must either provide a letter of permission from the owner <br />giving consentto the filing ofthisapp/icadon orthe propertyonvermustsign this application for <br />it to he accepted. <br />Property Description/Proposal <br />Address or General Location Z �y Co.,�><N �✓ �Z %y%�nr/f �'�✓ <br />Legal Description <br />Lcd4trwn C4N� C h <br />Property Identiflcation # (PIN #) 07. 30. 2-3.3/. o o5Z <br /># of Acres 7.O Z 00 Current Zoning 9-/ <br />0� �Type of Application (Please check the appropriate boxes): 13'0 <br />LL <br />L (�i1vN <br />der <br />11 Comprehensive Plan Amendment <br />500 <br />Rezonin <br />500 <br />Major Subdivision <br />700 <br />Minor Subdivision <br />350 <br />Planned Unit Development PUD <br />750 <br />PUD Amendment <br />400 <br />Conditional Use Permit/Amendment <br />R-1 R-2 <br />200• all others 400 <br />Interim use Permit/Amendment <br />400 <br />Variance <br />R-1 R-2 <br />200• all others 400 <br />Administrative Variance <br />R-1 R-2 <br />100 <br />Text Amendment zoning Code <br />400 <br />Text Amendment Other City Code <br />300 <br />Develop Review/Site Plan Review <br />400 <br />Wetland Alteration Permit <br />R-1 R-2 <br />200• all others 350 <br />Wetland Buffer Permit <br />R-1 R-2 <br />30• all others 100 <br />Easement Vacation <br />250 <br />Re -approval of Minor Subdivision or Plat <br />Minor Subd. 50• Plat 100 <br />Zonin Review of B -i District Pro osed Use <br />200 <br />Page 1 of 2 <br />