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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> 75-54- ss`i i <br /> APPLICANT: SI rno 7- Sim AJ Phone 7& - � <br /> ADDRESS: Wr) /?,ou,vOS V/ 4/1 I.✓ S"SJI2- <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 /> ❑ 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 018-' Owl to /Y1ouNOS v,E.4J s'S1iz <br /> Legal Description or Property Identification Number e6 - 3 o —2 3 3 54- 006 a-'7 <br /> Legal Owner: Name/Address rr a Y 'DEI—d21S 0 S i m vA) <br /> 6 &o v L-A-A49 o a & 'OS V)c-r. ) SS117._ <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> ❑ Single Family Dwelling • <br /> ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units ) <br /> Q/ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ . Other (explain) <br /> Property Classification: ❑ Abstract D rrens <br /> REQUEST: ,R 0-4N-RK) Ay6 E <br /> • <br /> *Please note: Applicant may be responsible for additional fees associated with the review of this request. <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. <br /> Signature <br /> $200/acre,minimum$200,maximum$1,000 Park Fund Dedication Fee <br /> 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 /> Develop./Site Plan Review $100/acre,minimum 100,maximum $500 Total Fees Paid 42D o•Do • <br /> Minor Subdivision $150 Date Paid –9a <br /> Major Subdivision $250 plus$250 deposit Receipt Number .13 eO <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 p TABLED 0 <br /> Date Pi O Planning Case No. 3 51- q a-- Admin.Account No. n/-421' <br />