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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPLICANT:_ .r ci r7/,-) Phone 7LgL- <br /> zS 0 <br /> ADDRESS 7 - . <br /> Street Ad•ress, ity, State, and Zip Code <br /> • <br /> Interest in Property (check appropriate box): <br /> • <br /> Af Owner of Property <br /> U Contras for Deed Owner <br /> ❑ Lessee, Operator, Manager <br /> Q Agreement to Purchase <br /> ❑ Other (explain) . <br /> Documentary evidence of applicant's interest in the property may be required before final Cay action of this request <br /> PROPERTY INVOLVED. <br /> Address/General Location <br /> OCeLegal Description or Property Identincation Number �,o�-ayr See---/--,3° a 3 - 33-coo <br /> 7-U/F's 3� mart e a3 skb•�C � <br /> Legal Owner: / J �' -t-e R r✓ --t•17<7 N •ga �+•of s- �gInst j e• <br /> Name/Xddress . . - ., ' ., wui <br /> 7� - 5- - - � - .. L/o ce A . 4 A - <br /> • <br /> i <br /> Present Use (check appropriate box): <br /> ❑ UndevelopedNecant <br /> Single Family Dwelling • <br /> 0 Duplex/Two Family Dwelling . . -_--_._ <br /> Multi-Family (No. of Units ) <br /> • <br /> Q Business/Commercial Establishment <br /> • Q Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: Q Abstract <br /> Torrens <br /> RE•DUEST: --TA4--(-- a Varr ;0nce_ t,� `� r <br /> a? ea o _ v �� S� Z Ga n u S� <br /> - cI - __ <br /> ....i���i.r.r .ERZ A - .- - Atfa % t <br /> -17 <br /> 'P!ease note: AppiRant may be responsible for acoitional fees associated with the r- few of this request. <br /> I HERE3Y DECLARE THAT THE ABOVE STATEMENT ARE TRUE / <br /> Signa - - <br /> Rezoni s=■:_tr <br /> • <br /> Cd/acre.minimum$200.maximum 51.000 Park Fund Dedication Fee <br /> R-1 to rR-2-S75.ail athers=00 Oats Paid <br /> wnartionai Use Permit R-1 to A-2-S5.ail others 52C0 <br /> 75 Receipt Number <br /> Coda Appeal $ <br /> OeveiooJSite Plan Review S100/acre.minimum 100.maximum SZCOTota! Fees P 75` - <br /> Minor Suooivision S150 aid <br /> n S2 A c Dara Paid q•„4, _`1'W <br /> Major Subdivisioplus 5250 seoasit Receipt Number Sa S - • <br /> Camp. ?!an Amendment SZCO • <br /> Wetland Alteration Permit S50 plus deocsrt datermineo by Staff Additional Fee Paid <br /> Wetland Surfer Permit S10 <br /> Panning Sign SE0 Cate Paid <br /> PUDE Receipt Number <br /> PUD Amendment 3150 <br /> Oats at final action <br /> Dam q5- APPROVED C OENIEL - T:,BL <br /> Planning Case No. 414 5 q `i co ,__-- - ., I <br />