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ri <br /> [flfl ©Rir ORItirfn COMMUNITY DEVELOPMENT DEPARTMENT <br /> • DEVELOPMENT APPLICATION <br /> 2401 Highway 10, Mounds View MN 55112 <br /> Parn+`n '0 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> •Applicant Information <br /> Name of Applicant [)`,Q- ' ,do t L 16 A.e,2,4 c'4 4.i Telephone 71--47- <br /> Address <br /> 1' -Address 7 7 Cv S �,�z,AJ GS LK ,2) Fax 7 "i - CO3 2-7$J <br /> MauNL 41d -s//L <br /> Interest in Property(check appropriate paate box) <br /> Owner of Property <br /> ❑ Contract for Deed Owner <br /> ❑ 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 /> Ash property owner must sign this application for it to be accepted. <br /> MP <br /> Property Description/Proposal <br /> Address or General Location 7 7 Co S,OZ'm14 1-K 4 ) <br /> Legal Description SN;6J ;-a /D. Gf ' AJ 26—F T ' k S 3 JA F r LOT 2-4.1 <br /> Property Identification#(PIN#) b(Q 3 0Z 3 3 at," <br /> 7 <br /> #of Acres , 5 <br /> Current Zoning 4-I <br /> Present Use Type of Application <br /> ❑ Undeveloped/Vacant a Comprehensive Plan Amendment $200 <br /> Single Family Dwelling 0 Rezoning $200/ac;min$200 max$1000 <br /> ❑ Duplex/Two Family Dwelling 0 Major Subdivision $250+$250 deposit* <br /> ❑ Multi-family Dwellings 0 Minor Subdivision $150 <br /> ❑ Business/Commercial Establishment 0 Planned Unit Development(PUD) $350 <br /> ❑ Industrial Establishment ❑ PUD Amendment $150 <br /> ❑ Other(explain) X Conditional Use Permit R-1,R-2$75;all others$200 <br /> ❑ Variance R-1,R-2$75;all others$200 <br /> ❑ Code Appeal $75 <br /> ❑ Develop Review/Site Plan $100/ac;min$100 max$500 <br /> ❑ Wetland Alteration Permit $50+deposit* <br /> ❑ Wetland Buffer Permit 7 <br /> O Floodplain Permit $200 <br /> �k ❑ Other <br /> J <br /> • <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />