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CM CF <br /> I <br /> 1 (42ii i % • COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> • <br /> :1: :;:1.7 2401 Highway 10, Mounds View MN 55112 <br /> 'le <br /> `"2s•PartneE°*'p' 612-717-4020 <br /> 612-784-3462 -FAX <br /> PleasePlType or Print Information-Complete Both Sides of This Form <br /> Applicant Information ' �`-r'r� <br /> Name of Applicant <�C a" '_:.1n,rc o c e .t& - Telephone 'ND--S 9(t.._47 <br /> Address o�c_j` cX 't( .10 vJ a c e C r .\ -' Fax <br /> Interest in Property(check appropriate box) ._ -,.,_ <br /> A. Owner of Property 0 Contract for Deed Owner <br /> O Lessee,Operator,Manager _ 0 Agreement to Purchase. <br /> ❑ Other(explain) <br /> Applicants must provide evidence of interest in prop rty 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 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 /> - <br /> Address or General Location t,,�wQA C2 rL� �i7w.�.pL� �le.A,;5"-- PI\/1 S S1 X2- <br /> Legal <br /> 2Legal Description <br /> Property Identification#(PIN#) t- ._ <br /> #of Acres <br /> Current Zoning <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment 5250 <br /> ❑ Rezoning $250/acre; min 5250 max$1500 <br /> ❑ Major Subdivision $250+$250 deposit* <br /> O Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) Refer to rezoning fees <br /> O PUD Amendment $350 <br /> X Conditional Use Permit R-1, R-- others$250 <br /> ❑ Variance R.I, R-2$ " all others$250 <br /> ❑ Code Appeal 5100 <br /> ❑ Develop Review/Site Plan $125/acre;min$I25 max$750 <br /> ❑ Wetland Alteration Permit R-1,R-2 5150;all others$200 <br /> • ❑ Wetland Buffer Permit R-1,R-2$25;all others$100 <br /> ❑ Floodplain Permit 5200 <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 after consideration of the application is completed. <br /> Please complete the reverse side of this application. <br /> 'S' S`Ce Le to <br />