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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Date <br /> APPLICANT: Name ,-//// //1A/ (/'A/1 Mc12 Phone 7G'- <br /> Address a Ed / 4;o G13C_RpS' >> 1llavNos V 1z W /OW 5'-5 Ii Z <br /> Interest in Property (check appropriate box): <br /> Owner of Record <br /> Lessee, Operator, Manager . <br /> Contractor for Deed Owner Agreement to Purchase <br /> Other (Explain) <br /> Documentary evidence of applicant'sinterest in the property may berequiredbefore final City action on this request. <br /> PROPERTY: Address/General Location ,;i;) (,y,:`c:J c/i ASi 4)2 <br /> Legal Owner: Name/Address /'.-//4,- /i4 // (iv%/VTWE tZ <br /> -21'0/ livGO:JC/i'EST' 1Jr' /hdu.•t.o" LI6•H/ iv(/Y ,7"5".1 <br /> L. <br /> • Present Use (Check Appropriate Box): <br /> Undeveloped/Vacant _~Apartment • <br /> x Single Family Dwelling r Business Esablishment <br /> • Duplex Dwelling Industrial Establishment <br /> J-1Multip a_Dwel.t nx (2-5 units) <br /> u Other (explain) <br /> Property Classification: Abstract Torrens _ <br /> REQUEST: (Explain) y`I/ bacx h, fI of cX,27ina <br /> : - - - - - - - - - _ - - rue. i ! . <br /> (signature) <br /> FOR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non Refundable) <br /> DEPOSIT FEES <br /> Subdivision, Maior $250 ($150) • TOTAL FEES PAID /m3 . 00 <br /> --Subdivision, Minor $100 ($75) p c9. 00 Date Paid 7_;2.3-f--�7 ) <br /> Rezoning $100 ($50) Receipt Number 254s <br /> Conditional Use $100 ($50) <br /> Variance $75 ($50) <br /> Code Appeal $100 .. . (S50) • <br /> Alteration Permit $150 (S50) <br /> Park Fund Dedication <br /> Date Paid <br /> Receipt Number <br />