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CITT OF MOUNDS VIEW - _ <br /> PLAN IIW ICA:O <br /> • • 7 ^AFFAPPLICANT: /�Z---,1-0-", � ��-,��,�T� Phone / 6:5--.2 ^�; <br /> ADDRESS: �yc.9' S.-- A / 2.-.3 ,y_,_�... l/ ._ //2.- <br /> Street Address, City, Stat-, and Zip Code <br /> Interest in Property (check appropriate box): <br /> Owner of Property <br /> Contract for Ceed Owner <br /> ❑ Lessee, Operator, Manager <br /> O 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: <br /> Address/General Location �`--r'ct: <br /> Legal Description cr Property Identification Number <br /> Legal Owner: Name/Address a ;f����1,y , _ <br /> / <br /> Present Use (check appropriate box): <br /> • ❑ Undeveloped/Vacant <br /> Single Family Dwelling <br /> Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: Abstract C Torrens <br /> REQUEST: &,.../ /j---),_— .Q4"��+ ..�Y'i �407-..c' <br /> *Please note: Applicant may be responsible for additional fees associated with the review of this requesr. <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. -'Y— �rJ./17-1-0er4- '-- <br /> - Signature / �- <br /> Rezoning 5200/acre, minimum $200, maximum $1,000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-£75, ail others $200 Date Paid • <br /> uonaltlonai use Perm R-1 to R-2-$75. ail others 5200 Receipt Number <br /> Gale At7peal $75 <br /> Develop./Site Plan Review $100/acre, minimum 100, maximum S500 Total Fees Paid '2 G) <br /> Minor Subdivision S150 Cate Paid - \- -yC <br /> Major Subdivision $250 pius $250 deposit Receipt Number %.-:.-5----7 =, 'Z <br /> • Como. Plan Amendment £200 — <br /> Wetland Alteration Permit S50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit £10 Cate Paid - <br /> Planning Sign $50 Receict Number <br /> P!'0 $350 <br /> RUC Amendment 3150 Date of final action <br /> .APPRCVED •_ DENIED i� TABLED <br /> / -2' _ o- <br /> Cate -- Planning Case No. % Admin. .Account No. <br />