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City of Mounds View,MN <br /> Development Application Page 2 <br /> Present Use of Property <br /> c Undeveloped/Vacant <br /> a Single Family Dwelling <br /> 0 Duplex/Two Dwelling Multi-family Dwelling `0 <br /> G Business/Commercial Establishment c Industrial Establishment I . . , <br /> C Other(explain) (�- . r <br /> I" ! - <br /> r fscMi <br /> lr <br /> Property Classification a Abstract C Torrers <br /> Description of Proposal (AOA1.yJ j ik U <br /> ?Kii-fr-t_ ae old feii ay .y � Co/red-if' Si:, cr I 2y _ 7- <br /> `3d ie •r Oc4e— ..��o.e_ po2 .v ifw,/ , 4�,c�1ri /i it-c# Aje., . G.i- A�� <br /> • <br /> •� A.Je - e 6010 b 1 ICC T1 � ",be)-771, <br /> alis' 4 IA/fi/ j/.Sr' fie &rel) . <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE ACCURATE. <br /> Signature of Applicant <br /> /Of'_ — <br /> Name of Applicant(typed/printed) Nei eea7c-" <br /> Property Owner ' <br /> Pro /''•cam' r �+" . <br /> Signature of <br /> Name of Property Owner(typed/printed) 1-77Ye..e r-e.. <br /> Address of Owner <br /> Phone Number of Owner • <br /> ************************************************************************************************ <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 7- - <br /> Date of Acceptance Adtingair <br /> Assigned to: <br /> Planning Case No. 60-day Limit 120-day limit <br /> Account# Check# Receipt# • <br /> Application: <br /> Fees P dop /04 7 .3�92 ,Q5c40�� <br /> !� <br /> Park Dedication: • <br /> Deposits: <br /> Other: • <br /> • Total: <br /> 1/98 <br /> N:\DATA\GROUPS\C OMDEV\FO RIMS\DEVAPP.FOR <br />