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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> A <br /> FPI!CANT: 1:7457 , /L-/-VM,LSPhone 641C-790 <br /> ADDRESS: aaa7 v/u/V Avc, 67 l�4U L, r�AJ. SS-114 • <br /> Street Address, City, State, and Zip Code <br /> interest in Prop (check appropriate box): <br /> Owner of Property <br /> Q Contract for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) <br /> Documentary evidence of applicant's interest in the property may be required before final City action of this request. <br /> PROPERTY INVOLVED: 2-5-77 JvNpUNQS v lbw } v'4 <br /> Address/General Location <br /> aeu 06 2-1000Z <br /> Legal Description or Property Identification Number O2- -? -.4 3--//- O '1 <br /> Legal Owner: Name/Address <br /> Present Use (check appropriate box): • <br /> Q UndevelopedNacant • <br /> Q Single Family Dwelling <br /> Q Duplex/Two Family Dwelling Ill Q Multi-Family (No. of Units __) <br /> -)E( Business/Commercial Establishment • <br /> ❑ Industrial Establishment <br /> ❑ Other (explain)_ <br /> Property Classification: ❑ <br /> Abstract Q Torrens <br /> � R `'�c-.s"% A- vA-R� c� -6 / <br /> REQUEST: w <br /> A w .. A <br /> 7a <br /> 1._.A. ,--L 5i‘xv ' <br /> 'Please note: Applicant may be responsible for additional fees associat-•. wig - •e <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. .. - fieri-e-e-- -9 - 2.5,----3z_ <br /> Signature ' <br /> Fund Dedication Fee <br /> Rezoning 5200/acre,minimum 5200.maximum$1.000 ewe Paid �" <br /> Variance R-1 to R-2-$75,all others$200 Receipt Number _— <br /> Conditional Use Permit �5 to R-2-$75,all others$200 <br /> Code Appeal Total Fees Paid .�i'fI�-�O <br /> Develop./Site Plan Review 5100/acre.minimum 100.maximum $500 Date Paide c)-; S0 <br /> Minor Subdivision $150 Receipt Number �2 <br /> Maim Subdivision $250 plus$250 deposit <br /> Comp. Plan Amendment $200 Additional Fee Paid <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional <br /> te Paid <br /> WetlandnninBuffer Permit $10 DReceipt Number • <br /> Planning Sign $50 <br /> PUD $350 Date of final action <br /> PUD Amendment $150 APPROVED 0 DENIED ❑ ) TABLED 0 <br /> �a S` l 3S — ?� Admin.Account No. 2 <br /> Date <br /> Gt1 � Planning Case Na. � <br />