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CITZ OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: Zarry / QC} - Phone 7�1D - 5-601- <br /> • ddb <br /> ADDRESS: 9 s/ /r/ <br /> /Al �,d <br /> Street Address, City, State, and Zip Code <br /> Interest in Property (check appropriate box): <br /> X] Owner of Property <br /> ❑ 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: <br /> Address/General Location '73 ) S,r�;��- �� #2, <br /> Legal Description or Property Identification Number La 2 EL U/L / <br /> ,)Y 4b115 <br /> Legal Owner: Name/Address .44-r y <br /> Present Use (check appropriate box): <br /> g UndevelopedNacant <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: 0 Abstract 0 Torrens <br /> REQUEST: Z.co 1454 L,'a e S d�i a r-s i o 1v o 4--4P <br /> _So fe ; A6 es a.•., A4 . <br /> *Please note: Applicant may be responsible for additional fees associated with e review of this request <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRU A --- k <br /> Sin$erre <br /> Rezoning $200/acre,minimum$200,maximum $1,000 Park Fund Dedication Far <br /> Variance R-1 to R-2-$75,all others$200 Date Paid <br /> Conditional Use Permit R-1 to R-2-$75,all others$200 Receipt Number <br /> Code Appeal $75 <br /> Dev ••./Site Plan Review $100/acre,minimum 100.maximum$500 Total Fees Paid r . oC� <br /> ;.r,:'-' ti;t. •. $150 Date Paid — - <br /> Nor Subdivision $250 plus$250 deposit Receipt Number 4-7 <br /> Comp. Plan Amendment $200 <br /> S Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> Planning n $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> a APPROVED 0 DENIED 0 TABLED 0 <br /> Date —Co - L-5 Flaming Case No. 0 q—l 5 Admin.Account No. <br />