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,, <br /> CITY OF MOUNDS VIEW • <br /> PLANNING APPLICATION <br /> Date /O— 90 <br /> P 0 <br /> / /� <br /> APPLICANT: Name 84/7/4 d 64R I? O,vlA/4 Phone 7?6- 6 >9 <br /> Address ‘ c)06--- GROVE//}i/c1 ROAe' rrovids V/6cJ1 rAh2 6511-1 <br /> Interest in Property (Check Appropriate Blank) : <br /> X Owner of Record Lessee, Operator, Manager <br /> — <br /> Contractor for Deed Owner Agreement to Purchase <br /> Other (Expl ain) <br /> Documentary evidence of applicant' s interest in the property may be required <br /> before final City action on this request. <br /> PROPERTY: Address/General Location S R m E <br /> Leyal Owner: Name/Address S A mF <br /> Present Use (Check Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> )c Sinyl e Family Dwell my Business Esabl ishment <br /> • Dupl ex Dwell myIndustrial Establ ishment <br /> Multiple Dwell my (3-6 units) <br /> Other (expl ain) <br /> Property Classification: Abstract Torrens <br /> REQUEST: (Expl ain) RElo6ATC- 6x/s72;Is GRR1456 ((Ac).41) To / 7A X6 ROOF" 102 <br /> /Jew CorJSTRUCT)oA KeeP of 6.7i/356! Fog �efsss�,ey but id aS s/bRPi c. <br /> A/6(A/ 5A-eil F �u",V as,' (67? f yy(O = // //a 5,u Nee Pe6 TO L <br /> I hereby decl are that the above statements are true. i C�.'av►l►J' aimdn-. itthAteafit <br /> (signature) <br /> FOR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non-Refundabl e) <br /> DEPOSIT FEES <br /> Subdivision , Major $250 ($150) TOTAL FEES PAID 33003 <br /> Subdivision , Minor $100 ($75) Date Paid 0-1a-- 0j0 <br /> Rezoniny $100 ($50) Receipt Number /0 ,0 b <br /> Conditional Use $100 —($50) )oo. °o <br /> Variance $75 ($50) <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> teration Permit $150 ($50) Date Paid <br /> 40hn Review $100 ($50) Receipt Number <br /> her ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> Receipt Number <br />