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a <br /> CITY Cf. . <br /> 011SIMEMI COMMUNITY DEVELOPMENT DEPARTMENT <br />' • I. <br /> DEVELOPMENT APPLICATION <br /> 2401 Highway 10, Mounds View MN 55112 <br /> �'`'' •par tut. Q' 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information <br /> Name of Applicant i enn e i h / /e C.O rn 3 Q. Telephone Tao-aro‹: <br /> Address 7150 f'SNOLLYV, Dt. Fax <br /> mOur-/S V4V.) SS1/Z <br /> Interest in Property(check appropriate box) <br /> a Owner of Property • <br /> o Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager <br /> ❑ Agreement to Purchase <br /> a Other(explain) <br /> Applicants must provide evidence of interest in property at the time of application,and if you are not the owner of the <br /> property,you must provide a letter of permission from the owner giving consent to the filing of this application. The <br /> property owner must sign this application for it to be accepted. <br /> Property Description/Proposal <br /> Address or General Location 7i—C° Jit/O LL l,(JOO/) Qt; /n a u nds Vi,j 2 53-112.- <br /> Legal <br /> Sl1ZLegal Description KNati w ot3 0 Fa k K, K'4' 1 t v .L(%7 Z <br /> • <br /> Property Identification#(PIN#) C.i. 7 - 3 O - Z3 - 3 / —00 -3 U — R <br /> #of Acres //r-rG/eF f- <br /> CurrentZoning /' ',- //51 ) <br /> Present Use Type of Application <br /> ❑ Undeveloped/Vacant a Comprehensive Plan Amendment $200 <br /> st Single Family Dwelling a Rezoning $200/ac;min$200 max$1000 <br /> a Duplex/Two Family Dwelling - a Major Subdivision $250+$250 deposit* <br /> a Multi-family Dwellings a Minor Subdivision $150 <br /> a Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> a Industrial Establishment a PUD Amendment • 50 <br /> ❑ Other(explain) Conditional Use Permit R-1, 'O`• others$200 <br /> a Variance- R-1,R-2$75;all others$200 <br /> a Code Appeal ' $75 <br /> a Develop Review/Site Plan $100/ac;min$100 max S500 <br /> a Wetland Alteration Permit $50+deposit* <br /> a Wetland Buffer Permit 7 <br /> a Floodplain Permit $200 <br /> a Other <br /> • � f <br /> C.4' � ,�� <br /> 6') <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br /> 1 <br />