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CITY OF MOUNDS VIEW <br /> PLANNING APPLICATION <br /> APPL!CAN IT: kR2 •/ EM.k <br /> Phone 9 F0 -SZar <br /> 0 ADDRESS: ( 9 7 Kii0 <br /> C J (1. 1'Ll U <br /> Street Address, City, State, and Zp Code <br /> Interest in Property (check appropriate box): <br /> ❑ Owner of Property <br /> ❑ Contract for Deed Owner <br /> -- <br /> O Lessee, Operator, Manager <br /> ❑ Agreement to Purchase • <br /> ❑ Other (explain) <br /> Documentary evidence of applicant's interest in lie property may be required before Spa! Cay aeon of tits request <br /> PROPERTY INVOLVED: <br /> Address/General Location 1153 2 - '15410 .51lver 2.4-ke. /2e4, cl <br /> Legal Description or Property Identification Number <br /> Legal Owner: Name/Address 10;c E:d;N '7532. 511aer- 2..a We. <br /> ?);II Co_ be r•-{- rl 5L o z r/ler 2_,...k . <br /> 'C.. <br /> Present Use (check appropriate box): <. <br /> ❑ UndevelopedNacant <br /> ❑ Single Family Dwelling <br /> • Duplex/Two Family Dwelling ./_❑ Multi-Family (No. of Units ) „ <br /> ❑ Business'Cammercial Establishment <br /> ❑ Industrial Establishment <br /> ❑ Other (explain) <br /> Property Classification: 0 Abstract Z Torrens <br /> RECUEST: -1-7\-4I , 6' / Fro►,., rl 5 3a ai.) J ax:18 4 <br /> `151-1t S; luer Lam,ke_ 2ac.,1. <br /> 'Pease note: Apeiicant may be resconsibie for accitional fees associated with e review cf:his request. <br /> I HERESY DECLARE THAT THE ABOVE STAT.ME.VT ARE TRUE. a 6)-421 <br /> Signa ire <br /> mleas=iexairivareir:+favi+fritsiri:weirs ei = iem=,►::tt..s,.m*,.ye,. y+tineYtrr:srr,rseine:xze <br /> Rezoning Z2C0/acre.minimum=CO—maximum Si.000 Paris Ftind Dedication Fee <br /> Variance r'i-1 to a-2•S75.sil.cittiers=CO Date Paid <br /> Conditional Use Permit P-1 n-2.575. ail Others S200 prompt Number <br /> Code Appeal 575 <br /> Deveioo Site Plan Review Si CO/acre.minimum 100.maximum S5CC Total Fees Paid /50. a ° <br /> 'Wor Sucgivision) si so Date Fe d <br /> a,cr Surbarviswn S250 pius 5250 decosit Receipt Numcer <br /> C.;mo. P!an Amendment S2C0 3 `rte / <br /> • Wetland Alteration Permrt S50 pus cecosct determined by Staff Additional Fee Paid <br /> Wetiana 3ufer Permrt SIO Cate Psd <br /> panning Sign $50 n'eceiat Number <br /> P'JO 5:350 <br /> PUD Amendment Si 50 Cate of 5nai =ton <br /> � <br /> APPSCVEO i_ DENIED' _ TAc��. <br /> Gate I O ^J 7-q (0 Panning Case No. `kLidnO — 't.r,0 Admin.Account No. AA, ''417' <br /> ` <br />