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City of Mounds View,MN <br /> Development Application Page 2 <br /> Present Use of Property <br /> ❑ UndevelopedNacant Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling o Multi-family Dwelling <br /> ❑ Business/Commercial Establishment ❑ Industrial Establishment <br /> ❑ Other(explain) <br /> Property Classification 0 Abstract Torrens <br /> ^ r <br /> Description of Proposal /A U .b : �' 1 a .� �'� � X i c / � JV' <br /> /yt e• >50N 12 RI b <br /> c 4/,z2 1.&w T n sE z <br /> �G c/ N I4-1i` I le" 4'12 4 es.//y->4 <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br /> Signature of Applicant <br /> Name of Applicant(typed/printed) t N A / b 77 lit <br /> Signature of Property Owner t <br /> Name of Property Owner(typed/printed) 0z)/1(. -/p X A14 G/< J.? E <br /> Address of Owner v /7 `- //,v/v.y c/,i9 d �J <br /> itfo i/A/%s `i/` C L - SIA( <br /> Phone Number of Owner 7 g Y' s"' v <br /> ************************************************************************************************ <br /> FOR OFFICE USE ONLY <br /> Date of Submittal $-13. t g <br /> Date of Acceptance Assigned to: <br /> Planning Case No. 60-day Limit 120-day limit <br /> Fees Paid: Account# Check# Receipt# <br /> Application: i 7 /06_36)..7 I 9 00 (' <br /> Park Dedication: <br /> Deposits: <br /> Other: <br /> Total: <br /> 1/98 <br /> N:\DATA\GROUPSCOMDEVTORMS\DEVAPP.FOR <br />