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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: SEAcin <br /> Phone 9F-0 —SGoi--- <br /> ADDRESS: H9 s---1 Kiiuo . NI 0 <br /> 11110 <br /> Street Address, City, State, and Zp Cade <br /> Interest in Property (check appropriate box): <br /> ❑ Owner of Property <br /> ❑ Contract for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) • <br /> Documentary evidence of applicant's interest in the property may be required before final City action of this request. <br /> PROPERTY INVOLVED: <br /> Address/General Location 11532 — 95 it Salver L,ke. i2< d <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address iD. i'c. k Ed►'NJ <br /> '7 5.3Z 6,'J der La fie <br /> ?1;11 C v lb e r-+- r1 S LI a . i/o 1A,,(•e.. <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> Al Duplex/Two Family Dwelling . - _ <br /> Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Cassification: ❑ Alastra Z • <br /> Torrens <br /> REQUEST: TW IoZ , 5 / Rrnm `153aJ add <br /> t-1 SL1t S; )uer L,let. en . -�� <br /> 'Pease note: Applicant may be responsible for accitiortal fees associated with e review of this request <br /> I HERESY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. <br /> +rmmle <br /> Signa re <br /> :xs:enrm:se.,eseirmm <br /> Rezoning 5200/acre.minimum$200.maximum 31.000 Paris Fund 0edication Fee <br /> Variance R-1 to R-2.S75.aii others 3200 <br /> Conditional Use Permit R-1 ti A-2-575.ail others 5200 Daae Paid <br /> Receipt Number <br /> Code Appeal $75 <br /> Deveiao 'Site Plan Review 5100/acre.minimum 100.maximum $500 Total Fees Paid <br /> inor Subdivision 5150 /'�'O• o <br /> rvis+on X50 pius 5250 deposit Oats Paid /', - /7 '-1' <br /> Receipt Number <br /> Como. Plan Amendment3 <-oZ/ <br /> S200 <br /> wetland Alteration Permit S50 oius deocsit daterminec by Staff Additicnai Fee Paid <br /> Wetland Suffer Permit SIO410 <br /> Planning Sign $50 Data Paid <br /> PUO Receipt Number <br /> Sa.40 <br /> PUO Amendment S150 Oats of find arson <br /> APPRCVED ❑ DENIED _ TASV <br /> Date f O 17- (o Planning Case No. uktiV) - "u0 <br /> Admin.Account No. 'N'. Yak- <br />