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t <br /> / ' <br /> • 7 <br /> CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Date -3----//--9/ <br /> APPLICANT: Name ., L rid SeS DaWd Phone 76S —��0_ <br /> 11II <br /> �� , <br /> Address 9032 Sc„ ly /14/-, <br /> Scam/sae �- N.g. /tial ,,;t t):cw <br /> Interest in Property (Check Appropriate Blank) : <br /> Owner of Record Lessee, Operator, Manayer <br /> Contractor for Deed Owner Agreement to Purchase <br /> — <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 d O3cP2 Sc,knnc/s7(6 J) 10,E. /tA64rila's ()ler,, <br /> /i e S % o-P 4,4- 9c4 ! Sr-rj La, e Pink /ii//s U1ew 4„•.-4(;/:0,1 ,9a,,s-7 (t. <br /> Leyal Owner: Name/Address nay ld G-d -tere's•c( 1---+01je5 <br /> Present Use (Check Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> X Sinyl e Family Dwell my - Business Esabl ishment <br /> Duplex Dwell i ny - Industrial Establ ishment <br /> Multiple Dwell my (3-6 units) • <br /> — Other (expl ain) <br /> Property Classification: Abstract Tors <br /> REQUEST: (Expl ain) T re..4;.,-. 0/4 G -,,,,. , } wA/z� /• �,//f• (?7.472r0t',r-,,i/4i <br /> 7�� n -.5.41.---‘,' /;�lr �� �e n 11 r 7f 4 e , IY� er r• ��r- %.-'-, <br /> I hereby decl are that the above statements are true. il,_ ,hisir i -�� <br /> siynat.'e) <br /> s <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 -76-00 <br /> Subdivision , Minor $100 ($75) Date Paid 4".a1 —91 <br /> Rezoniny $100 ($50) Receipt Number 35'!P S 7 <br /> Conditional Use $100 ($50) <br /> Variance $75 ($50) '75- a"v <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> Alteration Permit - $150 ($50) Date Paid <br /> Plan Review $100 ($50) Receipt Number • <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> Receipt Number <br /> SY.-7 03 <br />