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• <br /> CITY OF MOUNDS VIEW • <br /> f PLANNING APPLICATION <br /> APPLICANT: .A.t.I(A2S CeQ,E44460`,"4n. \AQ, Phone ^(di <br /> III ADDRESS:21c 4u \t.a-V <br /> iii t_rx Y_ Pt Ste.QRu. NikkiNikkiSS1 n <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 /> Z 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 MOUtjj t 1/4)q ty9' ac, 2_ <br /> U to q LoKik, t_p,., QD . <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address QAST Q.. E.O'-tr2.4Eic <br /> 22271 v►aluc.Qc.rN aV S—.9Ate_ <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> III 0 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 0 Torrens <br /> REQUEST: CCOLIo -riod AL, LSF)__ Q 'Arr- 'TO R A. LAQ.Zi,`?:_ <br /> ''L.Dv-,EY_. MAQ-' – tvlOuNIS:MN/t E-vJ QVc `4 S int t O <br /> 4-r.j `rEAi.. r INALI. .IC 1V. .! . VS .E.Ac'rtO0 <br /> %rrt. PL.Av.1 'V l _c I eP J Lg.— V.; <br /> Lg.—CZ t. . 1 <br /> *Please note: Applicant may be responsible for additional f associated wi the revie f •f tr est. <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TR . , Lt ' <br /> Signature <br /> ******************************************************************************************** <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-$75,all others$200 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 <br /> Major Subdivision $250 plus$250 deposit Receipt Number <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff40 Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED ❑ DENIED ❑ TABLED 0 <br /> Date Planning Case No. Admin.Account No. <br />