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I 471:'..f <br /> Cil <br /> Il ©jI[° COMMITNITY DEVELOPMENT DEPARTMENT <br /> • 1- DEVELOPMENT APPLICATION <br /> Zi;. 2401 Highway 10, Mounds View MN 55112 <br /> °�e:f.p,T�,eri /' 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information P , <br /> Name of Applicant 4/1.14-v41 Hori koro Telephone 766'Y rPJ�j <br /> Address ,;7 F U D 1 D Fax <br /> 1/4/161/ Y?QUI/ ' 5/ (- <br /> Injerest in Property(check appropriate box) <br /> V Owner of Property <br /> ❑ Contract for Deed Owner <br /> o Lessee,Operator,Manager <br /> ❑ Agreement to Purchase <br /> o Other(explain) <br /> Applicants must provide evidence of interest in property at the time of application,and if you are not the owner of the <br /> property,you must provide a letter of permission from the owner giving consent to the filing of this application. The <br /> • property owner must sign this application for it to be accepted. <br /> Property Description/Proposal n � Avf <br /> Address or General Location 2-' 0 e }- <br /> Legal Description I <br /> Property Identification#(PIN#) 0,p 156 7r7 W J5q & z <br /> #of Acres , "! <br /> Cin ent Zoning t I r74.-47-,- -i.-- <br /> Present <br /> Present Use Type of Application <br /> n Undeveloped/Vacant 0 Comprehensive Plan Amendment $200 <br /> u Single Family Dwelling 0 Rezoning $200/ac;min$200 max$1000 <br /> ❑ Duplex/Two Family Dwelling 0 Major Subdivision $250+$250 deposit* <br /> o Multi-family Dwellings ❑ Minor Subdivision $150 <br /> u Business/Commercial Establishment 0 Planned Unit Development(PUD) $350 <br /> VIndustrial Establishment ❑/ PUD Amendment $150 <br /> Other(explain) ,, Conditional Use Permit R-1,R-2$75;all others$200 <br /> 4I-A Veit 0'• fC47dAJ 0 Variance R-1,R-2$75;all others$200 <br /> ❑ Code Appeal $75 <br /> O Develop Review/Site Plan $100/ac;min$100 max$500 <br /> O Wetland Alteration Permit $50+deposit* <br /> ❑ Wetland Buffer Permit ? <br /> . ❑ Floodplain Permit $200 <br /> 0 Other <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. %�" <br /> X69 <br />