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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPUCANT: --/SROM L GS P65LT- t Phone l012 -785-7172- <br /> 0 <br /> 78.x-9/7Z0 ADDRESS: 5005 IAlooc vJn1 Tztk/E, Ma,iNc V1£:4 M&) EE//-2_ <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 BOOS V\I oobtAv l,'l D,zive <br /> ,t4orr,/os J►1=.,,J ,Vi„J ss-11 L RAAA sirY CauAl- <br /> Legal Description or Property Identification Number <br /> LaT 2LE tJD LAW AI 1-E2RAC..e 053933 .2"" ate'.-` <br /> Legal Owner: Name/Address .fei26owc N. i PAAAtLA M. ;�`Pei LTH4 <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNacant <br /> El Single Family Dwelling <br /> O Duplex/Two Family Dwelling <br /> 111/ ❑ Multi-Family (No. of Units ) <br /> ❑ Business/Commercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: 0 Abstract 0 Torrens <br /> REQUEST: LIND/ TID/JAL the Peg/oil-To 111IL,O 12.(..06D 2..caua2,E <br /> rr, 64rzptc, <br /> *Please note: Applicant may be responsible for additional fees associated withe review of this request <br /> I HEREBY DECLARE THAT THE ABOVE STATEMENT ARE TRUE. 't -- -1 -Xil l a ' ,�; <br /> Signature J • <br /> ******************,******************.,*******************************max=** <br /> Rezoning $200/acre.minimum$200,maximum$1,000 Park Fund Dedication Fee <br /> Variance R-1 to R-2-$75,all others$200 Date Paid <br /> Conditional Use Permit R-1 to R-4WD ail others$200 Receipt Number <br /> Code Appeal $75 <br /> Develop./Site Plan Review $100/acre,minimum 100,maximum$500 Total Fees Paid - '-)5. 00 <br /> Minor Subdivision $150 Date Paid (a— 7 —C1 ,_, <br /> Major Subdivision $250 plus$250 deposit Receipt Number 7 / <br /> Comp. Plan Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> 41, Wetland Buffer Permit $10 Date Paid <br /> / Planning Sign $50 Receipt Number <br /> PUD $380 <br /> PUD Amendment $150 Date of final action <br /> APPROVED 0 DENIED 0 TABLED 0 <br /> Date l.G` '7- in 4' Planning Case No. 4-1.01-- eg Admin.Account No. In <br />