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City of Mounds View,mr <br /> Development Application- Page 2 <br /> Present Use of Property <br /> • Undeveloped/Vacant Single Family Dwelling <br /> • Duplex/Two Family Dwelling 0 Multi-family Dwelling <br /> O Business/Commercial Establishment 0 Industrial Establishment <br /> o Other(explain) <br /> Property Classification 0 Abstract C Torrens <br /> _ - <br /> Description of Proposal <br /> - - - - - - - - - ---------- -------- <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 /> _ <br /> v-- *-ectj <br /> Signature of Applicant ovivv) <br /> Name of Applicant(typed/printed) <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) J ' \CA, <br /> Address of owner <br /> . . . . <br /> Phone Number of Owner 6v1 M(Z - <br /> ************************************************************************************************ <br /> FOR OFFICE USE ONLY <br /> Date of Submittal -/ - <br /> Date of Acceptance 7 Assigned to: •• • •-•- <br /> . <br /> Planning Case No. - 5-3 I- & 60-dav Limit 120-day limit <br /> Fees Paid: - • Account# Check# •• Receipt# <br /> Application: Ag 75 <br /> '7.3 9 <br /> Park Dedication: <br /> Deposits: <br /> Other: <br /> • <br /> Total: <br /> N:\DATA\GROUPS COMDEIAFORMS‘DEVAPP.FOR 1/98 <br />