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ii` CI3T OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: ��rr � at <br /> y Phone '7D - 57,E <br /> P <br /> , ' ApOAESS: 69s/ a// 4a/ ,D,4! /7/7,f'' Street Address, City, State, and Zp Code <br /> ',twist In Property (check appropriate box): <br /> EJ Owner of Property <br /> ❑ Contract for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) <br /> Dsot i nlMttsry evidence of applicant's interest in the property may•be required before final Gty action of this request. <br /> RERTY INVOLVED: <br /> Address/General Location 75-9?) .S.1,e,-- LJ P ,2..d, <br /> Lot jdl Description or Property Identification Number La 2 e3/o E./ / <br /> Leudl Owner: Name/Address .2-curry ,C.Jo.‘ <br /> prosint Use (check appropriate box): <br /> g 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 /> prof idity Classification: 0 Abstract 0 Torrens <br /> flf l,IJEST: .2.ro )•.4-ri 2/.a e . Su l X 7.- ibN 4r 7 / <br /> ,a1� <br /> J , � f a rs PS 0..) y;,rT �a.t. <br /> • <br /> *mania note: Applicant may be responsible for additional fees associated with; e review of this request <br /> ( I_ighkiY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. .a. „ ...---ig—ct.C.k • <br /> S . -ture <br /> N M 1 A•t;M••*************************************Mtif********* ********** *********tilt******** <br /> pr►pitNlNi $200/acre,minimum$200.maximum$1.000 Paris Fund Dedication Fee <br /> Violas*. R-1 to R-2-$75,all otters$200 Daae Paid <br /> teiulw� Use Permit R-1 to R-2-$75.all others$200 <br /> $7s Receipt Number <br /> 040411 10410 <br /> Plan Review $100/aa.,minimum 100,maxinurt$500 Total Fees Paid J S r t • 00 <br /> aM(4"1t + ) $150 Date Paid <br /> Moor gi,polwision $250 plus$250 deposit Receipt Number 4 —b% - S <br /> tio, Piot Amendment $200 `�7 `� <br /> wallow Animation Permit $50 plus deposit detemtired by Staff Additional Fee Paid <br /> wallow Wier Permit $10 Date Paid <br /> ►+1anr►MNi 44Ian $50 Receipt Number <br /> o <br /> $350 <br /> fau0 Ntt,xt,iment $150 Date of final action <br /> • <br /> �} APPROVED ❑ DENIED ❑ TABLED ❑ <br /> — �� Ptann'rp Case No. 40! -9 5 Admit.Aecount No. !7 / <br />