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f F <br /> CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> e, N7'4/ E- A/f4/ pea EIcorrCox, Date 2 - 7 ' 9.f <br /> NPP ANT: Name /209 7 X S'? Cao t/ /f o',aic/r, /yv Phone 7 5-7- 7 ser <br /> /i7NI $ 7`Eve d Gi:vd., /9eTE`re ren/. . ._ <br /> Address F-/ 7 7 rJe,o r.o,v7` �/,' d' Ca t,x 7- , ft9 i/, 7 -7 F5-2 <br /> Interest in Property (Check Appropriate Blank) : <br /> X Owner of Record Lessee, Operator, Manager <br /> Contractor for Deed Owner Agreement to Purchase <br /> Other (Explain) <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 X73 .S/�ctr,P J d o di freas4 I <br /> Z-41-. ,'j / ed 0i9* PivA <br /> Legal Owner: Name/Address dn,✓7`,.N e ,✓75r / j'Fv /,"f,,, 6.4/ <br /> Present Use (Check Appropriate Blank) : <br /> X Undevel oped/Vacant Let Apartment <br /> Single Family Dwell ing - Business Esabl ishment <br /> Dupl ex Dwell my - Industrial Establ ishment <br /> i Multiple Dwell my (3-6 units) <br /> Other (expl ain) <br /> Property Classification: Abstract Torrens <br /> REQUEST: (Explain) `Q <br /> I hereby decl are that the above statements are true. [�'�� S. '¢ali <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 /RS"-t)-4) <br /> Subdivision , Minor $100 ($75) Date Paid <br /> Rezoning $100 ($50) Receipt Number a9 <br /> Conditional Use $100 ($50) <br /> Variance $75 ($50) '76—•6r2, <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> /ration Permit $150 ($50) Date Paid <br /> Pg. Review $100 ($50) Receipt Number <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> Receipt Number <br /> 4lJoJ <br />