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CITY OF MOUNDS VIEW • -: <br /> PLANNING APPLICATION <br /> Date /--? 7,..9,9_ <br /> APPLICANT: Nameto <br /> rev► le ,k, A`-t-a�►Son <br /> Phone -6f9. <br /> 5 '- <br /> Address1$ QQ J cPet-y _Vr . _ • n � � • <br /> HoiS <br /> Interest in Property (Check Appropriate Blank) : <br /> Owner of Record Lessee, Operator, Manager <br /> Contractor for Deed Owner Agreement. to Purchase <br /> K Other (Exp.' ain) » cr 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 Saoo a„ a 1 li::-_)-6-• <br /> Legal Owner: Name/Address ,. r`/ tyla,-- MC( A`-5.eryl <br /> Present Use (Check Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> 2. Single Family Dwell ing Business Esabl ishment <br /> • <br /> Duplex Dwell my Industrial Establ ishment <br /> Multiple Dwell in (3-6 units) <br /> Other (expl ain) <br /> Property Classification: Abstract Torrens <br />;EQUEST: (Expl ain) 4i,p ,( pier. • — -e.2-'S <br /> • <br /> ere•y •ec are a t e above statements are true. _ <br /> (signature) • <br /> OR OFFICE USE ONLY: <br /> TOTAL BASE *(Base Fees are Non-Refundable) <br /> DEPOSIT FEES <br /> Subdivision , Major $250 ($150) TOTAL FEES PAID Jo o • oa <br /> Subdivision , Minor $100 ($75) Date Paid, i- a7 -9„1__ <br /> Rezoning $100 ($50) Receipt Number 3 -) 5-3_3 <br /> Conditional Use $100 ($50) foo. a o . <br /> Variance $75 ($50) <br /> • <br /> Code Appeal $100 ($50) Park Fund Dedication <br /> Alteration Permit $150 ($50) Date Paid0 <br /> Plan Review $100 ($50) Receipt Number. <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> 7/ g Receipt Number <br /> 33 9 -9 <br />