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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: k;fk OlSor\ - Mer f v i) �a/e r M ar ire/ Phone -7(e,3�-10 67 <br /> ADDRESS: `f7S0 ,PC-11, S-1-. S, UU. l.4-a.vey (7, NIA) S—S-J 90 • <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 U.S, � (0 ) e014,4, 1 .1 ' C- 1, <br /> Mot.,,„,,, U i eta i {�'1 l- - oZ.�ndsu i St vU.ie i'to p in��17j. CPA~ { <br /> Legal Description or Property Identification Number O7 - 3/)6c 79 -3 <br /> Legal Owner: Name/Address Pas-kr , {e.r r,�5es <br /> 7 <br /> ,2Univers; f✓e, c+. PA-,1) Mti CC )1z{-Jb77 <br /> Present Use (check appropriate box): <br /> ❑ 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 ❑ Torrens <br /> REQUEST: t/t;P i ilii' /;p-Cv V i^L L)t2L'V'Sa/e5 Of- rtrildit u.-- <br /> 6141 p yrril11'i <br /> >-.rn ,.,J iA t vI 16140 IT ftl1J JOiv'f 0 -4--ohG v &lr (glib <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. 4c,./(6.2",____ <br /> Signature <br /> Rezoning $200/acre,minimum$200.maximum $1,000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-$75,all others Date Paid <br /> Conditional Use Permit R-1 to R-2-$75.ail $200 Receipt Number <br /> Code Appeal $75 <br /> Develop./Site Plan Review $100/acre,minimum 100,maximum $500 Total Fees Paid ,)• 3 <br /> Minor Subdivision $150 Date Paid 4-/ IA)_.a/, <br /> Maior Subdivision $250 plus$250 deposit Receipt Number ',II,;r =� <br /> Camp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Starf Additional Fee Paid <br /> • <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 /> / , l APPROVED 0 DENIED 0 TABLED 0 <br /> Date Nk" D-3 _' i (1 Planning Case No. LI 3 Q-0(..,, Admin.Account No. 1" I - <br />