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City of Mounds View,MN <br /> Development Application • <br /> Page 2 <br /> Property Classification a n Abstract e Torres <br /> Description of Proposal ( 2671 Ctrt nA J J Ute„ POL'r)L4 - -a OC�� < ) J . <br /> .e <br /> • I (c& c 1 g <br /> nI _ V <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HERESY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br /> Signature of Applicant <br /> Name of Applicant(typed/printed) <br /> Signature of Property Owner - 4‘1.- <br /> _ <br /> Name of Property Owner(typed/prmted) -,>` ,3 9. &-joi L(.Udd ©r <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal <br /> Dace of Acceptance <br /> PIu+nmg Case Na Assigaed to: <br /> 60-dav Limit 120-dav limit <br /> • <br /> Fees Paid: Accotmt a C:,e k.T <br /> Application: <br /> Park Dedication: <br /> Deposits: <br /> Other: • <br /> Total: <br /> CMFFICZWPATAWPDOCSlADMINIFORMSDEVAPPSOR <br /> 1197 <br />