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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> • Date 9/i 3�4[ <br /> APPLICANT: Name --ra..,._,e,sQda-z s'as.r.,r.A,a'c Phone 5.4.a. <br /> Address to 5^a i %A.* A, B t-7d , u e re ai(c.l Pt k9. "S" 5 31-4 3 <br /> Interest in Property (Check Appropriate Blank) : <br /> Owner of Record 76, Lessee, Operator, Manager <br /> Contractor for Deed Owner Agreement to Purchase <br /> Other (Expi ain) <br /> � Q `i WAR. 1..4A.s QF Y <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 a co c. o Lei +4 <br /> Legal Owner: Name/Address <br /> Present Use (Check Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> • Singe e Family Dwell ing <br /> Dupl exBusiness Esabl ishment <br /> . Dwell my Industrial Establ ishment <br /> Mul tipl a Dwell my (3-6 units) <br /> Other (expl ain) iyot, LC 14 01-$E 94 RC. <br /> Property Classification: Abstract Torrens <br /> REQUEST: (Expl ain) Cetjctr lrue. v5rr ia$RJu.i-r s 0I P,�,t��Z' <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 <br /> jda'O9 <br /> Subdivision , Minor $100 <br /> ($75) Date Paid . q-J3-9 <br /> Rezoning $100 ($50) Receipt Number t1 <br /> Conditional Use $100 ($50) <br /> Variance .;$75 ($50) <br /> C Appeal •$100 ($50) Park Fund Dedication <br /> A ation Permit $150 ($50) Date Paid <br /> P1 .n Review $100 ($50) Receipt Number <br /> Other ($50) <br /> PLANNING SIGN . $-50 Addt'1 Fees Paid <br /> Date Paid• <br /> Receipt Number -=- <br />