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City of Mounds View,MN <br /> Development Application Page 2 <br /> Property Classification ls0 Abstract c Torras <br /> Description of Proposal • <br /> PUC L-A-c-� F0,2 C07 f ez-41) . 5 E ) -11-0a <br /> Lr pt. I L to I l`k--(a 6-74-0 1'F' '7 moi/`(/c <br /> l. v S t_O I <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 AC • -TE. <br /> Signature of Applicant / //c.c.s.- — <br /> Name of Applicant(typed/printed) A7, ,QC;4 Z 441 c77,12/fP/(.9 <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal ,�,w� ;.S i cm ) <br /> Date of Acceptance -L-4--11 15' .(k1. Ptv Assigned to: <br /> Planning Case No.. 60-day Limit c /2.3I1' 7 I20-day limit II 1/z.t)t <br /> Fees Paid: Account# • C'z T e71-03 <br /> Application: <br /> Park Dedication: <br /> Deposits: <br /> len <br /> Total: <br /> C:.OFF iCEti:/PWZI\WPDOCSIADIv@l1FORMS1DEVAPP.FOR 1197 <br />