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[11floii€G COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION • <br /> 0. <br /> = r 2401 Highway 10, Mounds View MN 55112 <br /> ^'weft-P-arrAtspy • 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form . <br /> Applicant Information M • <br /> _ <br /> Name of Applicant t' 1e-r.riv;\\e •}zt.rnn MrCet Telephone 4-(5?r''-iS72 <br /> Address G SK 1 5,....1 s cf Cf Fax <br /> S fe.v;c w>, (`1t•3 5-S,Z Ic <br /> Interest in Property(check appropriate box) <br /> a Owner of Property <br /> ❑ Contract for Deed Owner - <br /> , r. Lessee,Operator,Manager <br /> 0 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 riving consent to the filing of this application. The <br /> property owner must sign this application for it to be accepted. <br /> Property Description/Proposal ��r2 <br /> Address or General Location ('(•S. ""_7 1 0 2 Co v- v _. , ) - 10,,,y- s'> <br /> Legal Description <br /> Property Identification#(PIN#) <br /> #of Acres <br /> Current Zoning <br /> Present Use Type of Application <br /> a Undeveloped/Vacant ❑ Comprehensive Plan Amendment $200 <br /> a Single Family Dwelling a Rezoning $200/ac;min$200 max$1000 <br /> a Duplex/Two Family Dwelling 0 Major Subdivision $250+$250 deposit* <br /> a Multi-family Dwellings a Minor Subdivision 5150 <br /> � Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> o Industrial Establishment a PUD Amendment $150 <br /> a Other(explain) z.0 Conditional Use Permit R-1,R-2$75; • others£200 <br /> a Variance R-1,R-2$75;all o 1... i• <br /> a Code Appeal $75 <br /> a Develop Review/Site Plan $100/ac;rain$100 max$500 <br /> a Wetland Alteration Permit $50+deposit* <br /> a Wetland Buffer Permit ? <br /> a Floodplain Permit $200 <br /> 0 Other • <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />