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COMMUNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATION <br />.1. "NIM, 2401 Highway 10, Mounds View MN 55112 <br />A��'r=' PartnerSti�Q� 612-717-4020 <br />612-784-3462 - FAX <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information <br />Name of Applicant nQTOY MAI? <br />1) ick <br />Address d a5 Rece 0,4):f be. <br />Telephone (loZ 7�l —'� QS�9 <br />Fax <br />Interest 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 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 General Location <br />Legal Description <br />Property Identification # (PIN #) <br /># of Acres <br />Current Zoning <br />d & 3 Da.3 4kx o06Y -" <br />Type of Application <br />❑ <br />Comprehensive Plan Amendment <br />❑ <br />Rezoning <br />❑ <br />Major Subdivision <br />❑ <br />Minor Subdivision <br />❑ <br />Planned Unit Development (PUD) <br />❑ <br />PUD Amendment <br />❑Conditional <br />Use Permits <br />11CVariane <br />❑ <br />Code Appeal <br />❑ <br />Develop Review/Site Plan <br />❑ <br />Wetland Alteration Permit <br />❑ <br />Wetland Buffer Permit <br />❑ <br />Floodplain Permit <br />❑ <br />Other <br />$250 <br />$250/acre; min $250 max $1500 <br />$250 + $250 deposit* <br />$200 <br />Refer to rezoning fees <br />-,/R-1,=R),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 $150; all others $200 <br />R-1, R-2 $25; all others $100 <br />$200 <br />J3 f <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. Anv 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 />