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CrrY <br /> ii rg1 lTZ COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> ri ar 2401 Highway 10, Mounds View MN 55112 • <br /> ~ eft-P„mtn*o' 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 S hemi RLC( (Cor e 4a.f e of Le,N lsg 4 'elephone ��-�i / l i /Z I- /9,05 <br /> Address 13 3 SS 1-1 ea...±key- " 1 N lti' Fax 42/-2 5-1 7 <br /> ,4rcdover ; M 55301 <br /> Interest in Property(check appropriate box) <br /> ,fi2k Owner of Property -- xec c.-f o o F sfu f-� o� l e 5 �, G7oc�r i nv <br /> ❑ Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager <br /> ❑ 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 /> a 1&O (.t,00dci • <br /> Property Description/Proposal <br /> Address or General Location Sou--1\ ea + rAJA t- klelo Joh, ()ryt- <br /> Legal Description 1Dow'n ; � Ad.P i"Fa C ry oc± 1 Cofa , l�'f ou div ew <br /> Property Identification#(PIN#) () 7- 3 U - 2= - 7- 0 O 3 Z) <br /> #of Acres .c1 <br /> Current Zoning <br /> Present Use Type of Application <br /> Undeveloped/Vacant 0 Comprehensive Plan Amendment $200 <br /> ❑ Single Family Dwelling c Rezoning $200/ac;min$200 max 51000 <br /> a Duplex/Two Family Dwelling 0 Major Subdivision $250+5250 deposit* <br /> O Multi-family Dwellings 0 Mmor Subdivision $150 <br /> ❑ <br /> Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> ❑ Industrial Establishment a PUD Amendment S150 <br /> ❑ Other(explain) a Conditional Use Permit R-1,R-2$75;all others$200 <br /> a Variance R-1,R-2$75;all others$200 <br /> O Code Appeal S75 <br /> O Develop Review/Site Plan S 100/ac;min S100 max$500 <br /> ,S Wetland Alteration Permit 550+deposit* <br /> a Wetland Buffer Permit ? <br /> c 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 />