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CITE OF MOUNDS VIEW <br /> 2....? :r?F x: A.:?r%LI LT7 CN <br /> 1 I 34C Q <br /> APAPPLICANT: %-rAD Lv ( tt <br /> n�t,wcj 1ja224a <br /> � 1 Phone /1 c <br /> ADDRESS: 5 to\ O '� NM?tau $ mr4 s . <br /> Street Address, City, State, and Zip Code <br /> Ca � �. l <br /> Interest in Property (check appropriate box): ` ' .Je � � S <br /> j' Owner of Property °\'1 <br /> Contract for Deed Owner <br /> ❑ Lessee. Operator, Manager -� � ��`rr c,4 <br /> ❑ Agreement to Purchase -�•-��_c� e�p <br /> ❑ Other (explain) t7 U <br /> Documentary evidence of applicant's interest in the property may be required before final City action of this request <br /> PROPERTY INVOLVED: <br /> Address/General. Location 'Z l 5 5 14w ' <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address lw o I <br /> Present Use (check appropriate box): <br /> • ❑ UndevelopedNacant • <br /> ❑ Single Family Dwelling • <br /> ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units <br /> Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: ❑ Abstract ❑ Torrens <br /> REQUEST: SPP 3 'b p-2o�� �� • <br /> j v i <br /> Please note: Applicant may be responsible for additional fees associated Iwith the review of this request. <br /> 9 \LI <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRU 0 „ S <br /> Signature <br /> Rezoning $200/acre.minimum 5200.maximum 31.000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-$75,all others$2C0 Cate Paid <br /> Conditional Use Permit R-1 to R-2•375,all others 5200 Receipt Number <br /> Code Appeal S75 <br /> Develop.;Site Plan Review 5100/acre,minimum 100,maximum $500 Total Fees Paid /DO . VG <br /> Minor Subdivision 3150 Oate Paid Y0-079-- Q7 <br /> Major Subdivision 3250 plus $250 deposit Receipt Number `fCat5-/ <br /> Como. Plan Amendment 3200 <br /> Wetland Alteration Permit S50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit S10 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUD 3050 <br /> PUD Amendment $150 Date of final action <br /> nn APPRCVED r DENIED U TABLED Q <br /> Cate / (- <br /> 1 ~ Planning Case No. �lJo L Aomin.Account No. <br />