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TY TR <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> wEf772401 Highway 10, Mounds View MN 55112 <br /> p�'"tf Parrnet$°. 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 A Ian °E-am j -c- Telephone 6,)a-r7q9-6/(25. <br /> Address S a-10 to Pryld Fax <br /> MOt s \ .LOj mK 55)le <br /> •Injerest in Property(check appropriate box) <br /> Owner of Property a 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 /> = osaI c ni ` FaS` , ,� a - e ,n V i`r(�„) iC } t,--{A <br /> Legal Description Lot t E�No� 1 ?as f- �Kc <br /> Property Identification#(PIN#) C- O 31 I CO99 <br /> #of Acres Lai Si t x a ` I <br /> Current Zoning a i C.l e.Yl: -k9l <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> O 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 /> ❑ PUD Amendment $350 <br /> XConditional Use Permit R-1, R-2$75;all others$250 <br /> ❑ Variance R-1, R-2$100 all others$250 <br /> ❑ 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 />