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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Date //7/7.R <br /> APPLICANT: Name (ly� I 37,trieit/ Phone 27/ -77/ 7 <br /> Address ..._._. A-;,,,,- . <br /> Interest in Property (Check 'Appropriate Blank) : <br /> VO-wner of Record Lessee, Operator, Manager <br /> P � <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 a&•S_ /l/, /(/d /144.c •dC-e-L/ <br /> 6Legal <br /> Owner: Named/Address , y or.r,� , 211-3.5---x/ / ...., - ,oiy [/�i�rsi flit/ T S-sT//p.. <br /> Present Use (Check Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> 2( Single Family Dwell my Business Esabl ishment <br /> Dupl ex Dwell i ng Industrial Estabi ishment • <br /> Mul ti l e Dwell i n <br /> P y (3-6 units) <br /> Other (expl am) <br /> Property Classification: Abstract Torrens <br />;EQUEST: (Expl ain) G <br />--r .-�iy/ iynature) <br /> OR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non-Refundable) <br /> DEPOSIT FEES <br /> Subdivision , Major $250 ($150) TOTAL FEES PAID )00 . 00 <br /> Subdivision , Minor $100 ($75) Date Paid /,.../ -2-5,3_ <br /> Rezoning $100 ($50) Receipt Number .: 96/5?-t) <br /> Conditional Use $100 ($50) f©a.av <br /> Variance $75 ($50) <br /> Code Appeal $100 ($50) Park Fund Dedication - <br /> Alteration Permit $150 ($50) Date Paid <br /> Plan Review $100 ($50) Receipt Number11111 <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt1 Fees Paid <br /> Date Paid <br /> Receipt Number <br /> lLp <br />