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OTT li '<'It <br /> 3)3 HMO COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> •f.�nr cs.. <br /> •„moo f � 2401 Highway 10, Mounds View MN 55112 <br /> 4'"Pti-Partners`Ill 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 1 j c) A/ NA k 5 .e L= Telephone 7 g V"s6) <br /> Address. 0 // R l.) Fax <br /> /\i/ 4"v4.7s 1/1 e iv/ /7 A( <br /> 's11V-- <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 / cS v& (y c5-7 ,>9 R <br /> Legal Description .�C—P 'Lc.l.�l�t.t.c� J I sL <br /> Property Identification#(PIN#) D LQ 30 a3 M4 `f L -000(‘ <br /> # Acres e /1/ G / G k S p <br /> Current Zoning g • <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> O Rezoning $250/acre; min$250 max$1500 <br /> O Major Subdivision $250+$250 deposit* <br /> O Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) Refer to rezoning fees <br /> ❑_ PUD Amendment $350 <br /> S Conditional Use Permit R-1, R-2$75;all others$250 <br /> ❑ Variance R-1, R-2$100 all others$250 <br /> O Code Appeal $100 <br /> ❑ Develop Review/Site Plan $125/acre;min$125 max$750 <br /> ❑ Wetland Alteration Permit R-1,R-2$150;all others$200 <br /> O Wetland Buffer Permit R-1,R-2$25;all others$100 <br /> ❑ Floodplain Permit $200 <br /> ❑ Other <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 />