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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Datep0-00 0 <br /> APPLICANT: NamecPC)11 a. e(,,s ro✓1'1 1 \) 0U 4r'dl�s rUv1'1 Phone)c=( 572. <br /> j <br /> Address 05' /�SSy / QUA 0L ate,,, Dr( ti <br /> Interest in Property (Check Appropriate Blank) : <br /> Owner of Record Lessee, Operator, Manager <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 army,-q QS Q7 PcJv- <br /> Legal Owner: Name/Address c avn-e s 2,im c1 <br /> Present Use (Check Appropriate Blank) : <br /> Undevel aped/Vacant Apartment <br /> /7 nyl e Family Dwell iny Business Esabl ishment <br /> — <br /> Dupl ex Dwell iny Industrial Establ ishment <br /> Multiple Dwell iny (3-6 units) • <br /> Other (expl ain) <br /> Property Classification: JAbstract Torrens[ <br /> REQUEST: (Explain) -� c �Gi0i/L, c4 pa- h0 iU/ d•ill SI irS <br /> -c),'' b y -I- h (J ✓i s <br /> , <br /> O��i 1,,i v i If <br /> i s ynature <br /> FOR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non-Refundable) <br /> DEPOSIT FEES <br /> Subdivision , Major $250 ($150) TOTAL FEES PAID /5 0.0-0 <br /> Subdivision , Minor $100 ($75) Date Paid (o-ate -yd <br /> Rezoniny $100 ($50) Receipt Number 5 8 <br /> Conditional Use $100 ($50) <br /> Variance $75 ($50) <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> Alteration Permit $150 ($50) /,5•0. oca Date Paid I <br /> Plan Review $100 ($50) Receipt Number • ' <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt'1 Fees Paid -42(45-0, <br /> U <br /> Date Paid 6/.z6/90 <br /> Receipt Number • . 3 3 SSS-' <br />