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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Date &-Z6 <br /> A•CANT: Name , LL5Ss1$v‘LD11-4_ CDF4'a0,' - c't Phone 4Z9 — <br /> s0 ► .► o 1171 <br /> Address 4411/4 !),5-- 4 t.}6't, S - f 4, t \4 4 C(t gag_ <br /> Interest in Property (Check Appropriate Bl ank) : MH 5'5110 <br /> Owner of Record Lessee, Operator, Manager <br /> contractor for Deed Owner Agreement to Purchase <br /> Other (E x pl ain) .v., _ A.. I. te.,4-r- Foie. <br /> . -1 r 'Tb cfrvI4 6,,27-9 I <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 L.25-r ( gt. _ , . TPA L V-4401--\-S <br /> v StL-\ . L-4 cp-.Q t-litut\c l \l l MN <br /> Legal Owner: Name/Address VA.ILE-.4 t�n1 '. 11.1_. <br /> 11 exxD c .P <br /> eaks ,t_ N, Ni,i€ . 1 ..w.m Lb G.) Ism N . I Mt-i. 55`13.1 <br /> Present UseUs (Check Appropriate Blank) : <br /> ✓ Undeveloped/Vacant Apartment <br /> Sinyl e Family Dwell ing - Business Esabl ishment <br /> 0 Duplex Dwell my_ <br /> y - Industrial Establ ishment <br /> Multiple Dwelling (3-6 units) <br /> Other (expl ain) <br /> Property Classification: Abstract Cforrens <br /> J.E QU E ST: (Explain) '7b Co ac p� . 0i=t,Ef or-4 9,�111.3y L45-1- <br /> c--u -c'L-/ Q 1‹.--2. t <br /> her-b .- . - I . . - . .. - -„ - <br /> (siynature) <br /> "OR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non-Refundabl e) <br /> DEPOSIT FEES <br /> Subdivision , Major $250 ($150) TOTAL FEES PAID /(,b,a 0 <br /> Subdivision , Minor $100 ($75) Date Paid 6_ Zo -q d <br /> Rezoniny $100 ($50) Receipt Numbers 6?c <br /> Conditional Use $100 ($50) <br /> Variance $75 ($50) <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> 4 Off. ereration Permit $150 ($50) Date Paid <br /> n Review $100 ($50) Mme). otpReceipt Number <br /> ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> Receipt Number <br />