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[11flk ' O COMV MUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> " j rd <br /> 2401 Highway 10, Mounds View MN 55112 <br /> oba411-Partueooc'' 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information N� <br /> Name of Applicant t' 1e.ffy v.I rrw Max Let Telephone L('r'(—)S73 <br /> Address (,SKI S..-., s c± CT- Fax <br /> 51.•0,-.2_v i e,+,-!, (`'ilk S'S)2.6 <br /> Interest in Property(check appropriate box) <br /> ❑ Owner of Property <br /> ❑ Contract for Deed Owner <br /> ,g. Lessee,Operator,Manager <br /> ❑ Agreement to Purchase <br /> ❑ 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 /> perty Description/Proposal . <br /> Address or General Location [,(•S S . ►-{Iv.}/ 1 'D 2 ( c.v..n� . I. - V1 ov. Sv)2t)J S� le— <br /> Legal Description <br /> Property Identification#(PIN#) <br /> #of Acres <br /> Current Zoning <br /> Present Use Type of Application <br /> scan ❑ Comprehensive Plan Amendment $200 <br /> ❑ Single Family Dwelling ❑ Rezoning $200/ac;min S200 max$1000 <br /> ❑ Duplex/Two Family Dwelling ❑ Major Subdivision $250+$250 deposit* <br /> ❑ Multi-family Dwellings ❑ Minor Subdivision $150 <br /> Business/Commercial Establishment ❑ Planned Unit Development(PUD) $350 <br /> ❑ Industrial Establishment ❑ PUD Amendment $150 <br /> ❑ Other(explain) X Conditional Use Permit R-1,R-2$75; others$200 <br /> ❑ Variance R-1,R-2 S75;all o . - :. <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 /> ❑ Floodplain Permit $200 <br /> II <br /> 0 Other <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />