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WHIN COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> �` ' 2401 Highway 10, Mounds View MN 55112 <br /> •,e <br /> l::.ir i <br /> -4°4•Parmesi,Q' <br /> 612-717-4020 <br /> • 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> • <br /> Applicant Information <br /> Name of Applicant @R& {^,, <br /> e. e suN -0A tc.u.,o c) Etc,v lephone Z ko-L{q K b <br /> Address I' it 1-1:51...,-) to Fax '! ga - <br /> r i•.) L044 9..,1c, M,d 5S432 <br /> Interest in Property(check appropriate box) <br /> O Owner of Property a Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager 11 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 Ldi S /7 f 1 g [~6174 wvot( ‘5 ut( <br /> Property Identification#(PIN#) ()5 -3o-�� © ao-7 ---). <br /> #of Acres <br /> Current Zoning 12- <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> ❑ Rezoning $250/acre; min$250 max$1500 <br /> ❑ Major Subdivision $250+$250 deposit* <br /> ❑ Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) • Refer to rezoning fees <br /> o PUD Amendment $350 <br /> O Conditional Use Permit R-1, R-2$75;all others$250 <br /> O Variance R-1, R-2$100 all others$250 <br /> O Code Appeal $100 <br /> ❑ Develop Review/Site Plan $125/acr-• s• $125 max$750 <br /> Wetland Alteration Permit R-1,R $150- all others$200 <br /> ❑ Wetland Buffer Permit R-1,R- 25;all others$100 <br /> ❑ Floodplain Permit $200 <br /> 7 Other <br /> *Deposits shall be paid to coverall costs of public notices,materials and staff or consultant tune spent in the review, _ a - <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 /> = ..b <br /> �- t <br />