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an'OF <br /> [11fl 'i© ''= O CONLMITNITY DEVELOPMENT DEPARTMCENT <br /> DEVELOPMENT APPLICATION <br /> • "•,,� ; *z 2401 Highway 10, Mounds View MN 55112 <br /> °°''h-ru0+.n ° 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 C/2- $' til O e t_ 4A-eg4C4,ti Telephone 7 i'/- 'y 7-- <br /> Address 7 7 Cv 5 Z�c'N C; L I< A Fax 7 S"1 — C,Z7 <br /> A/11c.u4.1 b t// ., Md s- -j/f‘....- <br /> Interest <br /> -Interest in Property(check appropriate box) <br /> X. Owner of Property <br /> O Contract for Deed Owner <br /> O Lessee,Operator,Manager <br /> O Agreement to Purchase <br /> O 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 77C.,S Sp,Z..J C 2.4c 4 <br /> Legal Description 54 da-i -, Ia i ë.' .0 26—F7 $e k s 3 7P F7 L O r Z`1 <br /> Property Identification#(PIN#) c7(v 3 D Z 3"i-i o n n ,7 <br /> #of Acres . 5 <br /> Current Zoning 4-I <br /> Present Use Type of Application <br /> O Undeveloped/Vacant ❑ Comprehensive Plan Amendment $200 <br /> Single Family Dwelling 0 Rezoning $200/ac;min$200 max$1000 <br /> 0 Duplex/Two Family Dwelling ❑ Major Subdivision $250+$250 deposit* <br /> ❑ Multi-family Dwellings ❑ Minor Subdivision $150 <br /> O Business/Commercial Establishment 0 Planned Unit Development(PUD) $350 <br /> ❑ Industrial Establishment 0 PUD Amendment $150 <br /> O Other(explain) Conditional Use Permit R-1,R-2$75;all others$200 <br /> o Variance R-1,R-2 575;all others$200 <br /> _-_ o Code Appeal $75 <br /> ❑ Develop Review/Site Plan S 100/ac;min$100 max$500 <br /> ❑ Wetland Alteration Permit $50+deposit* <br /> O Wetland Buffer Permit 7 <br /> ❑ Floodplain Permit $200 <br /> ill 1,,I', 0 Other <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />