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COMMUNITY DEVELOPMENY DEPARTMENT <br />PLANN$NG APPIL.,ITCA` ZON <br />2401 County Road 10, Mounds View, MN 55112 <br />(763) 717-4020 * Fax (763) 717-4019 <br />permits@ci.mounds-aiemr.mn.us <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information <br />oI L� <br />Name of Applicant o n," 1 ;, r i Work # <br />r <br />Address ,_�J1 i r� t 1_ City li a ti' _(t� Statp V� K Zip x`,11 <br />Home # Cell # Fax # <br />E-mail <br />Interest in Property (check appropriate box) <br />:i, owner of Property <br />❑Agreement to Purchase <br />El contract for Deed Owner <br />❑Other <br />❑Lessee, Operator, Manager <br />Applicants mustprovide evidence ofinterestin propertyat the time of application, andifyou are <br />not the owner of the properly, you must either provide a letter of permission from the owner <br />giving consent to the filing of this application or the property owner mustsign this application for <br />it to be accepted. <br />Property Description/ Proposal <br />Address or General Location - -'T_i ^' IT, <br />Legal Description j <br />Property Identification # (PIN #) U ` ? — 2 7 - 21 - DO Lf <br /># of Acres U $ 5 Current Zoning 13.3 <br />Type of Application (Please checic the appropriate boxes); <br />Page I oft <br />Comprehensive Plan Amendment <br />500 <br />Rezoning <br />$500 <br />Major Subdivision <br />$700 <br />Minor Subdivision <br />350 <br />Planned Unit Developl?ient (PUD) <br />1$750 <br />PUD Amendment <br />400 <br />Conditional Use Permit/Amendment <br />R-1,_ R-2. 200; all others 400 <br />Interim Use Permit/Amendment <br />$400 <br />Variance <br />R-1 R-2 $200; all others t4OO <br />Administrative Variance <br />R-1 R-2_$100_ <br />Text Amendment,Zoning_Code <br />.400 <br />Text Amendmeni� Uther City Code <br />300 <br />Develop Review/Site Plan Review <br />-- <br />$400 <br />Wetland Alteration Permit <br />R-1, R-2$200; all others $350 <br />Wetland Buffer Permit <br />R-1 R-2 $30; all others $100 <br />Easement Vacation <br />250 <br />Re -approval of Minor Subdivision or Plat <br />Minor Subd. $501 Plat '100 <br />Zoniny Review of B-1 District Proposed Use <br />$200 _ <br />Page I oft <br />