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`. <br /> ICITY OF MOUNDS <br /> VIEW <br /> PLANNING APPLICATION. . <br /> APPUCANT: Axn-lavy dAi /i4 p Phone 7B/-2-03 <br /> ADDRESS: -3ColL-(1 S(//V•SaAl 5c,VO. <br /> Street Address, City, State, and Zp Code <br /> Interest in Propertt(check appropriate box): <br /> Owner of Property <br /> ❑ Contract far Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ❑ Agreement to Purchase • <br /> • 0 Other (explain) <br /> Documentary evidence of applicant's Interest In the property may be required before find City action of this request. <br /> PROPERTY INVOLVED: <br /> Address/General Location -96)S A o V VE._ <br /> —3o '' ` aii -0QS <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address 4VTA[ d O,t/44/4/ <br /> Present Use (checj/appropriate box): <br /> �� UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling <br /> O Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> 0 Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: ❑ Abstract ❑ Torrens <br /> REQUE T: (Ai e, -' 5 <br /> ? L �GA/V T DA( �- <br /> *Please note: Applicant may be responsible for additional fees associated w• ^ e r iew of this req est <br /> 1 HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUEAfrieef <br /> Rezoning 5200/acre.minimum$200.maximum$1.000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-S75.all others S200 Date Paid <br /> .'"1 iI, R-1 to R-2-S75.all others 5200 Receipt Number <br /> * S75 <br /> Develop./Site Pan Review $100/acre,minimum 100.maximum$500 Total Fees Paid 7.5• 0 0 <br /> Minor Subdivision SI S:1 Dame Paid <br /> Major Subdivision $250 plus S250 deposit *or. "/S �� <br /> Number t f'�(i <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Start Additional Fee Paid <br /> wetland Buffer Permit $10 Date Paid <br /> Panning Sign S50 <br /> PUD $350 Receipt Number <br /> PVD Amendment S150 Dane of&real aeon <br /> APPROVED 0 DENIED 0 JTABLED ❑ <br /> - <br /> Date cJ—/4- - (77 ---- Plannine c_ . w, 4-1//-' q,5— . , • _ l ,/1 <br />