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r 741 <br /> i %F'C COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> 2401 Highway 10, Mounds View MN 55112 <br /> A$�I=-Partnt(Sie' 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Iota-330-50i <br /> Applicant Information CV <br /> Name of Applicant „ <br /> N�ri1� ny . (�;y�it-{4- Telephone (a l -nc -1 's-)(G, <br /> Address . 3( to 14-Z Ilvte tuJ 2_00A Fax <br /> n..'dS1 v ke J M ►� <br /> SStt� <br /> Interest in Property(check appropriate box) <br /> X Owner of Property ❑ Contract for Deed Owner <br /> ❑ <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 LocationO(n E}:l` V\e vJ tZo M�t�, d S V �,�; >N1 55 ( 1 a„ <br /> Legal Description <br /> Property Identification#(PIN#) <br /> #of Acres <br /> Current Zoning <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 /> O Planned Unit Development(PUD) Refer to rezoning fees <br /> O PUD Amendment $350 <br /> Conditional Use Permit R-1, R-2$75;all others$250 <br /> ❑ Variance R-1, R-2 S100 all others$250 <br /> O Code Appeal 5100 <br /> ❑ Develop Review/Site Plan S 125/acre;min S125 max$750 <br /> ❑ Wetland Alteration Permit R-1,R-2$150;all others$200 <br /> ❑ Wetland Buffer Permit R-1,R-2 S25;all others S100 <br /> ❑ Floodplain Permit $200 <br /> O 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 atter consideration of the application is completed. <br /> Please complete the reverse side of this application. <br />