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City of Mounds View, MN <br /> Development Application Page 2 <br /> Present Use of Property <br /> Undeveloped/Vacant 0 Single Family Dwelling <br /> Duplex/Two Family Dwelling 0 Multi-family Dwelling <br /> Business/Commercial Establishment 0 Industrial Establishment <br /> D Other(explain) <br /> Property Classification 0 Abstract 0 Torrens <br /> Description of Proposal D'1 TO 2 5u. b cI'U i S/p v`i <br /> BY MY(OUR) SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDEDl IS TRUE AND ACCURATE, <br /> Signature of Applicant LU2VACQZ—Q 4;171/4--49:k <br /> ' <br /> Name of Applicant(typed/printed) cT �1(SNti, <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) <br /> Address of Owner <br /> Phone Number of Owner <br /> FOR OFFICE USE ONLY <br /> Date of Submittal *jou,rn v (Z, I ct5 <br /> Date of Acceptance t2. Assigned to: "— <br /> Planning Case No. S J-1(—9 A 60-dav Limit I - 120-day limit 3-(1- <br /> Fees Paid: Account# Check* Receipt T <br /> Application: Z co `;`' <br /> Park Dedication: <br /> Deposits: >C <br /> Other: <br /> Total: <br /> V`DATA\GROUPS\COAMDEV\FORMS\DEVAPP.FOR 1,98 <br />