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City of Mounds View,MN <br /> Development Application Page 2 <br /> • <br /> Property Classification ❑ Abstract 0 Ton-ens <br /> Description of Proposal .i t fI-alvtst5 ;"v--LzeN procuLQ. 0. <br /> Ill& friasvic.-) to — 7PM; 74.a1s o. .Neek �t,, ly 1 Setk 2J <br /> • <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS ACCURATE. <br /> Signature of Applicant <br /> Name of Applicant(typed/printed) <br /> Signature of Property Owner • <br /> Name of Property Owner(typed/printed) • <br /> • <br /> ***** ********* ************************************* <br /> FOR OFFICE USE ONLY <br /> Date of Submittal - — .,Z 9 - Q <br /> Date of Acceptance Assigned to: <br /> Planning Case No. 0-3.3 - 9 7 60-day Limit 120-day limit <br /> Fees Paid: Account# Check# d a.L <br /> Application: c-L <br /> Park Dedication: � . 417 <br /> Deposits: S 5 i 301. <br /> Other: <br /> Total: <br /> CAOFFICE1WPWWWPDOCS1ADMINNFORMSOEVAPP.FOR 1/97 <br />