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CITY OF MOUNDS..1i'IEZV,: <br /> PLANNING:APPLICATION <br /> APPLICANT:r/laLi n_ r V ir.P-; - -- Phone 7YY 3Oss <br /> ADDRESS: aL70 /U - _ - <br /> Street Addre City,State, and Zp Code <br /> Interest in Property (check appropriate box). <br /> Owner of Property _ - <br /> D _ centrad for Deed owner <br /> Q Lessee, Operator, Manager <br /> ❑ Agreement to Purchase <br /> ❑ Other (explain) -`' <br /> Document ty evidence of applicant's interest In the property may be required <br /> beforefinal City action of this.req <br /> uesL <br /> PROPERTY INVOLVED ° <br /> Address/General Location ga(a ,-1 <br /> Legal Description or Property Identification Number ir,;(43Oa 3x23 aoo3 <br /> —1-he S a7 1+ enc t a icZ t'-I- f1-P Lo+ 03 4 <br /> Legal Owner: Name/Address <br /> _ �� t� )r21 -r-4- fid- l nt 314 <br /> Present Use (check appropriate box): <br /> ❑ Undeveloped/Vacant .._ <br /> Single Family Dwelling <br /> • • Duplex/Two Family Dwelling <br /> "` 0 Multi-Family (No. of Units ' , <br /> ❑ Business/Commercial Establishment <br /> ❑ - Industrial Establishment <br /> ❑ Other:(explain) <br /> Property Classification: - Q Abstract -'" 0 Torrens <br /> RECDUEST: <br /> 'Please note: Applicant may be responsible for aaditional fees associated the review of this request <br /> I HE'EBY DECLARE THAT THE ABOVE STATE ME4T ARE TRU: / A A_ „%/�� <br /> Slgnai�e <br /> ago,linrant ife-Rinttririniriroriroriiiiinkireiror <br /> Rezoni • 5200/acts.minimum$200.maximum Si.000 P- - Dedication Fee <br /> R-1 to R-2-$75.ail others$200 Date Paid <br /> - 'anal Use Permit R-1 bdR-2-S75.ail others$200 Receipt Number <br /> Cade Appeal 575 <br /> Deveioo./Site Plan Review S100/acre.minimum 100.maximum $500 Total Fees Paid <br /> Minor Subdivision S150 Date Paid <br /> Major Subdivision $250 pius SZ50 deposit Receipt Number <br /> • Coma. ?lar Amendment $200 <br /> Wetland Alteration Permit $50 plus deposit determined by Staff Additional Fee Paid <br /> Wetland Surfer Permit Si 0 Date Paid <br /> Planning Sign $50 Receipt Number <br /> PUO $350 <br /> PUD Amendment $150 Date of final acron <br /> APPROVED ❑ DENIED [ TASL D ❑ <br /> Date Planning Case No. Admin.Account No. <br />