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CITY OF MOUNDS VIEW <br /> PLANNING CAT % - <br /> APPLICANT: • 1 '/—, L,D'-g4 - one 7, - z7/ 72 <br /> i - 0 <br /> - J . <br /> ADDRESS: , -7775t/1217410 <br /> Street Address, City, State, and Zip Code . <br /> \O <br /> Interest in Property (check appropriate box): Cierk X <br /> ❑ Owner of Property <br /> El Contract Contract for Deed Owner <br /> ®' Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) It <br /> Documentary evidence of applicant's interest in the property may be required before final City action of this request <br /> • <br /> PROPERTY INVOLVED: <br /> Address/General Location i' 9 '7 Y 44(-4 a.�,,,T <br /> `'(1�0k.>"Q 5 O ill SS'e,..� <br /> Legal Description or Property Identification Number C) F, - 3 0 - 2 3 - 12- a 0 s 1 -9-0 z/ if <br /> Legal Owner: Name/Address 6 1.< sr S1,. 1 k (-)'ec.Q_ Oa-t'--. e' <br /> h iv .( S 1 p i ifft A ‘5—S.'-.1 -. <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> • ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units ) <br /> Zy"' Business/Commercial Establishment <br /> o Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: ❑ Abstract j2r.Torrens <br /> REQUEST: o i . — 2 - , - f r <br /> • r <br /> - - - A • „ _ • _ e► �. _ I1 I. Z ' <br /> t. <br /> ie '. I Ay //f7!esAcre, Al /Ice Aro 'APS elle' , a .. . . 0(44'1"c <br /> ease no e: p cant may be responsible for additional fees associated with the review of this r:• estp,e y.. bay <br /> / <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRU .4 `. " w _ „„ <br /> 1r Signature <br /> ************ ********** ************************ <br /> R.zoning $200/acre,minimum$200,maximum $1,000 Park Fund Dedication Fee <br /> Van R-1 to R-2-$75.all others$200 Date Paid <br /> itional Use Permit , R-1 to R-2-$75,all others$200 Receipt Number <br /> Code $75 <br /> Deveiop./Site Plan Review $100/acre,minimum 100,maximum$500 Total Fees Paid <br /> Minor Subdivision $150 Date Paid <br /> Major Subdivision $250 plus$250 deposit Receipt Number <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Buffer Permit $10 Date Paid <br /> • <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED 0 TABLED ❑ <br /> Dam 5-- N " 9 Planning Car No. 11 4- -5-Admin.Account No. <br />