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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION i`=-" - <br /> • �� ' ,j- x <br /> C .35'6 <br /> APPLICANT: Lit!OEQ'S L �-t'CLS'1 tNIC_, Phone 4(".:; - ( C) <br /> • ADDRESS: -2:1 . -\.ki,Yrtt ..- Q kc- CO,CL.- NAK-1 5311 ) <br /> Street Address, City, State, and Zip Code <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 Nv;t:,tacLV t i..V�J t)c Q _ C pl r�[., C�i�j-1? <br /> ' ,\r..N to cPL. L.�w.i.G, L.i dc.L i2-D. <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address 1-)1112_, E_t•1-`ti1.9Q.tSt% <br /> `Z-Z'L-1 L;+..iKiF k-r--f ax4R '—, PAS`. N.n.o.:l <br /> / <br /> Present Use (check appropriate box): <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 /> Property Classification: 0 Abstract ❑ Torrens <br /> REQUEST: a 1.ik;rT1 l t..ip L'Sti_ k ►i -- C95:iSITTE P, El- <br /> f\ACZ; ,T1 NA0-1-UN 1CL� �C�;A-Z2..z SSv f- 1 t'- Q-:�CL1j <br /> i'.,_1 iL QL:—fwd J 1"�_�l�.i. :t l- (...-F, 175' T <br /> *Please note: Applicant may be responsible for additional fees associated with the review ofrisii est. <br /> �_ 3� i.- <br /> 'ç\) <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. --- \_,;(,......l ,� . ` -- <br /> Signature <br /> Rezoning $200/acre.minimum$200.maximum $1,000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-$75.all others $200 Date Paid <br /> Conditional Use Permit R-1 to R-2-$7.r.S l others k Receipt Number <br /> Code Appeal $75 <br /> Develop./Site Plan Review $100/acre, minimum 100,maximum $500 Total Fees Paid '"(.)' <br /> Minor Subdivision $150 Date Paid i.. - ! 4-'- <br /> Major Subdivision $250 plus $250 deposit Receipt Number -7� i-, .,L <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> 4110 <br /> S . <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED 0 TABLED 0 <br /> Date J 7.1 j Planning Case No. Admin.Account No. <br />