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CITY OF MOUNDS VIE .
<br /> PLANNING APPLICATION -
<br /> APPLICANT: M Ou.tA c(S V t.e 4 Ct. h Phone 784- 'M
<br /> ADDRESS: ,A ).80 W . C-+-t . RA . .1 Mo i v,d2svies.J, yt1,1 .
<br /> Street Address, City, State, and Zp Code o w r.a r,S
<br /> SS'i/i
<br /> Interest in Property (check appropriate box): To rh, MRK k,,,
<br /> ®' Owner of Property a..0 t fl f.esuote - _ ' C,34-.5g71—
<br /> ❑ Contract for Deed Owner ss I t 11V-s85551—
<br /> ❑ Lessee, Operator, Manager
<br /> ❑ Agreement to Purchase L2�o.re� #+i. M+J •' 3 S55v
<br /> a� . ,;,.J •
<br /> ❑ Other (explain) �� co U. a.. 4 Le . I o-4 1 .` '7'
<br /> •
<br /> Documentary evidence of applicant's interest in therop S 1,,c)re W e.g.);. fix xst 11. .
<br /> p erty may be required before final City action of this request. A Cr
<br /> PROPERTY INVOLVED: .
<br /> Address/General Location 2, ago - LU . C-{• . R6Z 1
<br /> /Ytott4cQSvi J /'►'\ N Cr4".7,/ I--
<br /> Legal Description or Pro erty Identification Number G- -1::) -Ji 3 --/ - ,Jr 5)
<br /> C
<br /> �t--70 ,v,,; t-,-/(Q__. ^v, it /._./i ,i i.?! r. 45 2v.1- l_-L: 6 4 2/X ) //^ ' / / r
<br /> Lsgal"Own+sr: Name/Address .�, ..,):,,.h,,,,,,:- , 1 J,- /r i'e„. /
<br /> Present Use (check appropriate box):
<br /> v�L� ��'1 SS'i�•
<br /> ❑ UndevelopedNacant
<br /> ❑ Single Family Dwelling
<br /> ❑ Duplex/Two Family Dwelling •
<br /> ❑ Multi-Family (No. of Units )
<br /> ' Business/Commercial Establishment
<br /> ❑ Industrial Establishment • -
<br /> ❑ Other (explain)
<br /> •
<br /> Property Classification: 0 Abstract 0 Torrens
<br /> REQUEST: 1;f�c: e_ - .
<br /> *Please note: Applicant may be responsible for adaitionai fees associated with the review of this request
<br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE.
<br /> Signature
<br /> Iett,rtttttti.ri.x,K*ilevntrir ,.*,.,n.,.i,..=,..,.*.tst.,t,.=.,.itraeri. ,r* r+Fi.,HreriMi,.*,.,t+etorx,.,. xit it rsri.
<br /> $200/acre,minimum$200.maximum S1.000 Pant Fund Dedication Fee
<br /> R-1 to R-2-375,ail others$200 Date Paid
<br /> - Use Permit R-1 to R-2-S75.ail others 5200 Receipt Number
<br /> Cade Appeal $75
<br /> Deveiap.jSite Plan Review 5100/acre.minimum 100.maximum 3500 Total Fees Paid t,.
<br /> Minor Subdivision 5150 7
<br /> Date Paid _%1_ -,r
<br /> Maior Subdivision $250 plus$250 deposit Receipt Number
<br /> C.:mp. an Amendment $200 —
<br /> Pan
<br /> Wetland Alteration Permit S50 plus deposit determined by Staff Additional Fee Paid •
<br /> Wetland Buffer Permit S10 Date Paid
<br /> Panning Sign $50 Receipt Number
<br /> P-JO $350
<br /> PUO Amendment 5150 Date of final ac000n
<br /> APPROVED ElDENIED 1-1 TABLE; ❑
<br /> Date 3/q 17 C fa; Planning Case No. I l F - C /r Admin.Account Na. l�i•-.?
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