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-4EMMICEMiw) IIMMEIMMIgnib <br /> I I <br /> V rim <br /> CODILZYITy DEVELOP1YtENT DEP_4RTy `iT <br /> ,,; DEVELOPMENT APPLICA.TION <br /> ' 2401 Highway 10, Mounds View Mir 551 I2 • <br /> 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 John R. Peterson e • <br /> Tel. <br /> j ephone • 755=9793 <br /> Address 9445 E. River Road Fax 755-6207 <br /> Coon Rapids, Mn 554.33 <br /> Good Value Homes, Inc. <br /> Interest is Property(check appropriate box) -- <br /> Owne:of Prcocv . <br /> a Catlin=for Deed Own= --• <br /> a Lessee,Op rator,Manage <br /> • <br /> a Aj r e ent to Purchase <br /> C CM=(captain) - <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 Gccai Location. <br /> Legal De, doa <br /> LbctS I-? F ( EV6 uDm SOU r4 <br />• P:opcty Idensification#(Pal i <br /> Oaf?.ate <br /> Ca:-._.t Zoning — <br /> P--�.ct Use Type ofAapti,catioa <br /> C Uttde:etopeti/V <br /> neat C eve Pact A mr^rfmrtr CO <br /> (-. Bugle.staiiy Dwelling <br /> Dttoie�JTwo ramiiyDw - $t-^rr+ncr <br /> 1 =CO/a min O m,T,cStOCO <br /> C :Nffuiti_: g Ma or Subdivision S2S0-S25.0 dost <br /> :ataiiy Dwe�.lings C N(iaor Subdivisionc <br /> a BZrsnma <br /> esseComc--:al Esrabl►chrft—rSI O <br /> F.2=1 Uar evcaIImctt(PUD) ASO <br /> a IcdustrarsEstablishmentiD . <br /> C Cchc(cL a) C .PUD Amendment SISO <br /> C . Cal Use Pmt R-1,RZ S75;all antes=00 <br /> • Ver, R-I,R.-2.S75;ad othcs X00 <br /> C ' Code Anneal S75 <br /> C, Deioo Role"Sire Plan S I00/a0 =in SICO aac 1500 <br /> WC.; d Altcaaon Putt SSO r-d osis' <br /> W r i Httrrc-?mit 7 <br /> a Foodatata.Pmt 5200 <br /> CatelIl <br /> Mai Code for e':tplanation of do asits <br /> Please complete the reverse side of this application. <br />