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CITY OF MOUNDS VIEW <br /> MPLANNING APPLICATION <br /> •ri I�`J ", r <br /> APPLICANT: " 1 4 v'0 S S t E c VA Phone 17SIio - 4'y <br /> - <br /> ADDRESS: g 4 " ;I\ \Q_� ( }a ,1 IJ Yr . <br /> Street Address, City, State, and Zap Code <br /> Interest in Property (check appropriate box): <br /> ,F] Owner of Property <br /> ❑ Contract for Deed 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 A J,-J- <br /> k-) `: L D \' <br /> Legal Description or Property Identification Number <br /> Legal Owner; NanAddress- 0 c , o <br /> ^ <br /> i17- kc. ( kk' _. k. ,, . i \ iU i,..)t ! . LC' , 1 <br /> ' 4 \ (\ 5-5-11'1-- <br /> Present <br /> 51/1iPresent Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> Single Family Dwelling0 <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 ❑ Torrens <br /> REQUEST: .L_ }:�7_ 7 7? , �. <br /> *Please note: Applicant may be responsible for additional fees associated.with the review of this request <br /> , <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. d-1Le - <br /> Signature <br /> Rezoning $200/sore,minimum$200,maximum $1,000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-575,all others$200 Date Paid <br /> Conditional Use Permit R-1 to R+2��eli others$200 Receipt Number <br /> Code Appeal $75 <br /> Develop./Site Plan Review $100/acre,minimum 100,maximum $500 Total Fees Paid '7S `1° <br /> Minor Subdivision $150 Date Paid ; - ? - -?'S— <br /> Maior Subdivision $250 plus $250 deposit Receipt Number u .11,—:,-,-.7- <br /> Comp. <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 /> Planning Sign $50 Receipt Number <br /> . PUD $350 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED ❑ TABLED p <br /> Date l,�,-A i '5 Planning Case No. Admin.Account No. <br />