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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> 12APPLICANT: 1- cc/ c:aC % Phone 71 iu-j bib <br /> ADDRESS: (09 51 KoE 1 Wei 0cl DR. ni\pONvc s 1 _tA) <br /> Street Address, City, State, and Zip Code <br /> Interest in Property (check appropriate box): <br /> ❑ Owner of Property <br /> ❑ Contract for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ,gf Agreement to Purchase • <br /> ❑ Other (explain) <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 ,280 I Z ro A)%o ,J 280 9 13 ro N so A) <br /> Legal Description or Property Identification Number L d+ /CI c d Ldp- / / <br /> JCI Nq L ' ke. 7a.r rc k c.), II-S <br /> Legal Owner: Name/Address C ko r(est Neq�� x€30 t !3 ro• l Se)n , <br /> 2 <br /> 5 co++ IC I,N di Q. .283? 6/0 S b?0 h7e, <br /> Present Use (check appropriate box): <br /> UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> ❑ <br /> Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: rg. Abstract ❑ Torrens <br /> REQUEST: i'V Qor bd: of sic, 10 , i i C4 P-er 5f«-A , <br /> i2 e2o.vt��c yr s /b i I -Prowl 2-I -1-c, (L-Z <br /> *Please note: Applicant may be'responsible for additional fees associated with the review lvi2of this request <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. ALAR _r,•. <br /> Signature <br /> aning (j acre,minimum$200,maximum$1,000 Park Fund Dedication Fee <br /> ance R-1 to R-2-$75,all others$200 Date Paid <br /> Conditional Use Permit R-1 to R-2-$75,all others$200 Receipt Number <br /> Code Appeal $75 <br /> Dev an Review $100/acre,minimum 100,maximum$500 Total Fees Paid 35'0'(3° <br /> Minor Subdivision C 415b Date Paid /o-3- q_6 <br /> • ubd!vision 4250 plus$250 deposit Receipt Number y q/p g7 <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED ❑ _ TABLED ❑ <br /> Date 9- Planning Case No. ‘47- C).>"'- Admin.Account No. /4"--"t/'7 <br />