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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> • APPLICANT: , r-r✓y "Eer eJ Phone '7f D-5 &e <br /> ADDRESS: (9,57 45/4/04a/ I7/1,-uC i7i7 <br /> Street Address, City, State, and Zip Code <br /> Interest in Property (check appropriate box): <br /> ❑. 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 73ot— ,(/,,.,e/4.1ed d <br /> Legal Description or Property Identification Number (D7-30-01,_ cf-)9 3 <br /> Loe- A A_k.. 14.41 5) 'I! se- <br /> Legal 14Nvner: Name/Address 1..a,112.x/ Zee LA <br /> Present Use (check appropriate box): <br /> • <br /> O UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling <br /> O Multi-Family (No. of Units ) <br /> Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: [ Abstract 0 Torrens <br /> REQUEST: P/CgSe See 7)2442�`ia,� <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 TRUE. aA <br /> Si tura <br /> "' ' 5200/acre,minimum $200,maximum $1,000 Paris Fund Dedication Fee <br /> R-1 to R-2-S75,ail others$200 Dasm Paid <br /> • morn • - Use Permit R-1 to R-2-$75,all others$200 Receipt Number <br /> Code Appeal 575 <br /> Develop./Site Plan Review 5100/acre,minimum 100,maximum $500 Total Fees Paid 00. o0 <br /> Minor Subdivision $150 Date Paid -ice - c; <br /> Major Subdivision $250 plus S250 deposit Receipt Number r i <br /> • Comp. Plan Amendment S200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit S10 Date Paid <br /> Planning Sign S50 Receipt Number <br /> PUD S350 <br /> PUD Amendment $150 Dose of final action <br /> APPROVED 0 DENIED o TABLED 0 <br /> Data - " a 5 P1eming Came No. '' `- - / -5 Admin.Account No. 1' /7 <br />