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` OF <br />A� ul::a :47Ji <br />0 <br />8ntf ' Partners'�a4' <br />Applicant Information <br />Name of Applicant <br />Address <br />Please <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />DEVELOPMENT APPLICATION <br />2401 Highway 10, Mounds View MN 55112 <br />or Print Information - Complete Both Sides of This Form <br />L LY -7,57o L S f ti Sf, <br />114111 5-�-'390 <br />612-717-4020 <br />612-784-3462 - FAX <br />Telephone _ le <br />Fax <br />Interest in Property heck appropriate box) <br />❑ Owner of Pr erty ❑ Contract for Deed Owner <br />Lessee, Op ator; Manager ❑ Agreement to Purchase <br />❑ Other (expl ) <br />Applicants must vide evidence P p r 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 j/ 5'a �� a. S <br />Legal Description <br />Property Identification # (PIN #) 0 - a _ 1) <br /># of Acres <br />Current Zo g 16 <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 Use Permit <br />❑ <br />Variance <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 />$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 $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 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 complete the reverse side of this application. <br />