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City of Mounds View,MN <br /> Development Application Page 2 <br /> Property Classification X Abstract ❑ Torrens <br /> Description of Proposal /.v C kS Sig r:o or,4-‘ o F 7-,4.6^‘ 6'At ie,-G <br /> F,zsti, BCvy i z 'Td 11 X( 4:1-7" CivC,2eiase of 32 - -- ) <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND ACCURA U . <br /> Signature of Applicant Qat <br /> Name of Applicant(typed/printed) D £ A e G f <br /> • <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) d L 1 ,Q 4„<. <br /> • <br /> ******************************************************************************************** <br /> FOR OFFICE USE ONLY <br /> Date of Submittal <br /> Date of Acceptance 4/ - Z <br /> Assigned to: <br /> Planning Case No. /--=`:77- ?7 60-dav Limit , ->o ") 120-day limit - -i '7 <br /> Fees Paid: Account# Check <br /> Application: `7 5 �d"�(� SSo O a <br /> Park Dedication: <br /> Deposits: <br /> Other. <br /> • <br /> Total: <br /> C`OFFICEIWPWMWPDOCSWDMI IIFORMS\DEVAPP.FOR 1/97 <br />