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r---CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: 1 a_v-r\rn�` a_.\\ei m Phone -3q�6 <br /> Imo. i J r <br /> ADDRESS: (PISS ! ► ne woc� 'br. f-)b�f�cS V )l•,u, 1(Lfn- D 1-D 0 <br /> Street Address, City, State, and Zp Code <br /> Interest in Property (check appropriate box): <br /> X 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 ec~.,on of tia request. <br /> PROPERTY INVOLVED: <br /> Address/General Location o"1.1 ST f i ne,,,r,t 'jr. <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address 'Ta_,r,-\a,„rck. y t ee,l,0_rn y <br /> Present Use (check appropriate box): <br /> ❑ Undeveloped/Vacant <br /> Single Family Dwelling <br /> ❑ . Duplex/Two Family Dwelling . . .. . - - -- . ---. r. -, <br /> ❑ Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Cassincation: ❑ Abstract 0 Torrens <br /> REC U ES T: To lea..,-..30,a k o. itiia t {.U bet . , i .ad- kcs ..e..�-C C,�.� <br /> 1. �e c` e1 oto„:„.„5- ,,,,,,_6_ `D -,...- ---A, 4-(,. Jr_ _'+� `0Mdi.2-, <br /> *Please note: Applicant may be responsible for acciticnal fees associated with the review of this request. <br /> I HERESY DECLARE THAT THE AECVE STATEMENT ARE TRUE. --1 — `0-in`�. <br /> Signatu it <br /> Rezoning $200/acre.minimum$200.maximum 51,000 Psrk Fund Dedication Fee <br /> Variance R-1 to R-2-S75.aii others=Oa Date Paid <br /> Conaiiianai Use Permit R-1 to R-2-S75.ad others$20 Receipt Number <br /> Code Appeal S75 y. <br /> Deveico.iSite Pan Review 5100/acre.minimum 100.maximum $500 Total Fees Paid +t'75" ° <br /> Minor Sucaivision 5150 Date Paid I/I t..4/ it i <br /> Maroc Suoaivision S250 pius$250 deposit Receipt Number 7 LL 1 1,:i I <br /> Cama. Pan Amendment $200 <br /> weuana Alteration Permit $50 plus deocsa determines by Ste Additicnai Fee Rid • <br /> Wedand Surfer Permrt S10 Cate Paid <br /> Panning Sign S50 neceiot Number <br /> PUD $50 <br /> PUD Amendment $150 Care of final ac-on <br /> APPROVED E DENIED 77 T:EL-7 <br /> Date i1 '1 - cil Panning Gass No. .Admin.Account No. <br />