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• CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT: ow c c A. Pt`c k Phone 717 Z2 <br /> ADDRESS: Z72 S. 51,.e�woo t (Zo�a( Moo r.-dc /AN/ x 5112 <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 /> Q Lessee, Operator, Manager <br /> ❑ Agreement to Purchase • • <br /> Q Other (explain) <br /> Documentary evidence of applicant's interest in the property may be required before final City acton of this request <br /> PROPERTY INVOLVED: <br /> Address/General Location Z.7 2 (fid E car off' R / o k <br /> rJ��ve u Sl.�r�o�c CZ��d) <br /> Legal Description or Property Identification Number L4 z 5(k 1 Qv_d k Park <br /> 0G 36 o <br /> Legal Owner: Name/Address 'i C. s A , Peck <br /> 2-72 S 5(.�� d �/, 1U ds �/;e�•• MN SS. 2... <br /> Present Use (check appropriate box): <br /> ❑ Undeveloped/Vacant <br /> • rir Single Family Dwelling <br /> 0 Duplex/Two Family Dwelling <br /> " ❑ Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> Q Industrial Establishment <br /> O Other (explain) <br /> Property Classfication: �j Abstract 0 Torrens • <br /> REQUEST: 7 er t v^�� -f aro.. � ct.< 7 .rot <br /> Lc.k comer e-P 4.)%.e. oma-{— i.e. RSL. v6.lc Dr;'e, 0 L R i oa.IC:.; <br /> ( C.-Cle. co r t- err vz.�¢ L 1\f rrrh.:e I {a ra.L.ce not Se. -f^ro 124.C.oak (,bv57 c.-,d c2 S t <br /> .•.d. b�ic Gerd. Fe},ci a tc�c* -R t, 4L C -}r ,f i { <br /> riwu vc F rea�c a c u,oco r.�Gora fol <br /> 'Please note: Applicant may be responsible for additional fees associated with the review of this request .. k"r L 0d• <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRU <br /> Signature <br /> wore.. itiehlritiririevroririelneiritirine <br /> _ $200/acre.minimum$200.maximum Si,000 Park Fund Dedication Fee <br /> "(titan= R-1 to R-2-$75.ail others$200 Date Paid <br /> .r.anal Use Permit R•1 to R-2-$75.ail others$200 Receipt Number <br /> Code Appeal $75 <br /> Deveicp./Site Plan Review 5100/acre.minimum 100.maximum $500 Total Fees Paid S S) 7 GIS <br /> Minor Subdivision 5150 Oats Paid <br /> Major Subdivision $250 plus$250 deposit Receipt Number <br /> Comp. Plan Amendment $200 <br /> 1110 Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland 6utfer Permit $10 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUD $350 <br /> PUD Amendment $150 Date of anal actan <br /> APPROVED 0 DENIED 0 maim Q <br /> Gate —) 6 _q Cp Planning Case Na. 7 y q CO Admin.Account No. 1 1n ` <br /> V <br />