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l4 yr MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: /YI ow..,A IQs I/f e w <br /> ADDRESS: a Agp W Phone 78�--��6. <br /> . L Rce . I' <br /> • e Street Address, City, State, and Z MO w.`cQs v.e�� „J . <br /> Interest in Pro p Code ......____OLQ hers <br /> Property (check appropriate box): '- <br /> i� Owneisof Property �O yh m�K �., " <br /> ❑ Contract for Deed Owner t3.0 l 01f�e.v.r&R.✓ 1 - 36-5�" <br /> ❑ Lessee, Operator, Manager Ilse <br /> ❑ Agreement to Purchase AN n1 • sS 1 13 33; <br /> ❑ Other �'' <br /> (explain) gin�.2a► 11•+�4_r <br /> Documentary evidence of applicant's interest in $�o ���}}Y SI-8404'�+ <br /> the Property may be required before final k ity of l"` � <br /> PROPERTY INVOLVED: ;°" of this request." g' <br /> Address/General Location a a.80 <br /> • w . c. 1'ecq, 1' <br /> o.e /h° t'`"` `' s vie....) fv' <br /> o rty Identification Number _ � " <br /> Lego! Description or Pr <br /> �9�dOwner': Name/Address -,� . •„ •)5 v y - <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant 'Z-,) 5S/ (,- <br /> ❑ Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling <br /> ❑ Multi-Family (No. of Units <br /> • Business/Commercial E ,' <br /> 1 <br /> ❑ Industrial Establishment lishment <br /> ❑ Other (explain) <br /> Property Classification: <br /> ❑ Abstract 0 Torrens <br /> REQUEST: 1 0 .:me_ <br /> ''lease note: Applicant may be res.... :_ _ _ <br /> -•� ees associated with the review of this request <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TAUS. , <br /> ****************.ank-** * Signature <br /> $200/acre. ,►*,t********,►,r***,r*,e*,r,t,r***********,r,e*,r* <br /> minimum$200,mum$1,000 Park Fund Dedication Fee <br /> R•1 to R-2-375,all othersthers 5200 <br /> Cade Appeai Use Permit $7R-1 <br /> to R-2-375.all others$200Re <br /> Date Paid <br /> Develop./Site Plan8ipt Number <br /> Mirror Subdivision Review $100/acre,minimum 100, <br /> $150 maximum$500 Dotal Fees Paid <br /> Major Subdivision $250 Date Paid 7 <br /> Camp. Plan Amendment $200 plus $250 deposit <br /> Wetland AlterationReceipt Number <br /> Permit $50 plus deposit date -...2_-___,- <br /> Wetland Buffer Permit determined by Staff <br /> Fannin 310 Additional Fee Paid <br /> PUD 9 sign $50 Date Paid <br /> 0 PUD Amendment Receipt Number <br /> $150 <br /> Date of final action <br /> APPROVED 0 DENIED 0 TAB <br /> LW <br /> 3/ /Cf <br /> PlanningLEJ <br /> Case No. % C - fo <br /> Admin.Account No. n -;+=j <br />