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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> r+ APPLICANT: rz rt-V eQeJ7 Phone '?"D-5-Zee <br /> ADDRESS: 69s/ 4o//ir0o2 l�/2i-uC 7V <br /> Street Address, City, State, and Zip Code <br /> Interest in Property (check appropriate box): <br /> EL Owner of Property <br /> ❑ Contract for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) <br /> Documentary evidence of applicant's interest in the property may be required before final City action at this reguest <br /> PROPERTY INVOLVED: <br /> Address/General Location r1305- ,(/,,.,d l f wad el 0 , <br /> Legal Description or Property Identification Number /7 -30-d,_ A z,, -t*)3,. -c4 <br /> -�,(v_.- 'a L1_3Le- AA.zc i7 m.af9 5) l iJ G5' .u. _.2s.... .. i/ y-- Ji.� <br /> Legal C?vner: Name/Address ,,1..C4 d!Z y t aL ' <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> 0 Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units ) <br /> gy Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: 15 Abstract ❑ Torrens <br /> REQUEST: i/:!BSc Sic 474e22 G4i <br /> • <br /> *Please note: Applicant may be responsible for additional fees associated witha review of this request <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE _� <br /> Si tune <br /> ** * <br /> •** * * <br /> ****** **********W** * <br /> *.:**#********* *****.***�********* * *************** ** <br /> Vrit <br /> S200/acre.minimum $200,maximum 21.000 Park Fund Dedication Fie <br /> %\ L�-�-•i R-1 to R-2-$75.ail others$200 Date Paid <br /> .: ~-' - Use Permit R-1 to R-2-S75,ail others S200 <br /> Cade Apoeal Reeaiot Number <br /> S75 <br /> Devaiop.iSita Plan Review 5100/acts,minimum 100.maximum $500 Total Fees Paid _. 00 <br /> Minor Subdivision $150 Date Paid ,—'y -- 4, <br /> Major Subdivision $250 plus $250 deposit Receipt Number _:7T' <br /> Comp, Plan Amendment $200 t <br /> Wetland Alteration Permit S50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Butter Permit 310 Date Paid <br /> Planning Sign S50 Receipt Number <br /> PUO $350 <br /> PUD Armond/mat $150 Dee at fs,ei action <br /> APPROVED ❑ DENIED 0 TABLED ❑ <br /> Dee - `l a SPlmrYp Case No. .:..1-:-).4:...:*.( '- �-5 Admin.Account No. r' �7 <br />