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II c COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> '?1 2401 Highway 10, Mounds View MN 55112 <br /> �6�trt•�r�+�n '�y 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 '?1 �R\{El J1 j f G eL6 � t4 L , Telephone 11(2)3"'S3 <br /> Address 4 la L Aet iffpi 4 . Fax qf3 3 5—Coq 2_ <br /> sStZG, <br /> Interest in Property(check appropriate box) <br /> a Owner of Property <br /> X Contract for Deed Owner <br /> a Lessee,Operator,Manager <br /> a Agreement to Purchase <br /> ❑ 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 1(,()s ID <br /> JP-46 GJ w � <br /> Legal Description �� �2� Lwr <br />• Property Identification#(PIN#) <br /> #ofAa-es t . <br /> Current Zoning (3-Z ( t 'L)0 raeo-pce ) <br /> Present Use Type of Application <br /> a Undeveloped/Vacant a Comprehensive Plan Amendment $200 <br /> a Single Family Dwelling c Rezoning .•. .5200 max 51000 <br /> a Duplex/Two Family Dwelling X Major Subdivision S25 -��, ••., <br /> -- Multi-family Dwellings a Minor Subdivision <br /> a Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> a <br /> Industrial Establishment a PUD Amrzr4mp-+r S150 <br /> =' <br /> Other(explain). a Conditional Use Permit R-1,R-2 S75;all others 5200 <br /> a Variance R-1,R-2 S75;ail others 5200 <br /> a Code Appeal S75 <br /> A Develop Review/Site Plan S 100/ac;min$100 •• S500 <br /> a Wetland Alteration Permit S50+deposit* <br /> a Wetland Buffer Permit ? <br /> a Floodplain Permit $200 <br /> a Other <br /> • <br /> 'see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />