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(w-) s7a- les'oZ1 <br /> CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> Date - 72 • <br /> APPLICANT: Name Gf�,„ e,,i / ,' v1 Phone l`7T'9--/393 <br /> AddressC? ? Gc-)un tv id /1 ilvcrncS v 2 c vv 19.1 6 .--112.- <br /> Interest <br /> .-”/1ZInterest in Property (Check Appropriate Blank) : <br /> X Owner of Record Lessee, Operator, Manager <br /> — <br /> Contractor for Deed Owner Agreement to Purchase <br /> Other (Expi 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 3009 Cou.1 fy Pe/ II-- heti �i:.,,c"r 144n SS/I2 <br /> Lcit P'S) ex <br /> C /)*- we.S/ 2S fico V)ell-ea t, ilcno/1 tivaeri pcirK <br /> Legal Owner: Name/Address,. /'eye,., /, ct S%e%/q, l3c�fckri <br /> ,?eat- .7 �ilOA / /IC/ /LT, 110Urie-A ✓�, ii- yil 0 6--c---,/,,„Present Use (Check/ Appropriate Blank) : <br /> Undevel oped/Vacant Apartment <br /> X Single Family Dwell ing Business Esabl ishment • <br /> Duplex Dwell my Industrial Establ ishment <br /> - Multiple Dwell my (3-6 units) <br /> - Other (expl ain) <br /> — <br /> Property Classification: Abstract Torrens <br /> REQUEST: (Expl ain) 8 ;/, „ r di r 4 - - o ,C7 s h <br /> ,'Z1471 r i v e IA/CI y /'c r n H AP, cwt" /7- pre S e c,t'' dp,ve. wcv <br /> I hereby declare that the above statements are true. cS2 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 611, )so. <br /> Subdivision, Minor $100 ($75) Date Paid a - 4 -q a <br /> Rezoning $100 ($50) Receipt Number 37s41,5— <br /> Conditional <br /> 7s4Conditional Use $100 ($50) <br /> Variance $75 ($50) <br /> Code Appeal $100 ($50) Park Fund Dedication • <br /> Alteration Permit $150 ($50) 1 70'w Date Paid • <br /> P1 an Review $100 ($50) Receipt Number <br /> Other ($50) <br /> PLANNING SIGN $ 50 Addt'l Fees Paid <br /> Date Paid <br /> Receipt Number <br /> 7a I <br />