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art Cr <br /> _ <br /> [ © . COMMUNITY DEVELOPMENT DEPARTMENT <br /> . DEVELOPMENT APPLICATION <br /> :JEW2401 B ghway 10, Mounds View MN 55112 <br /> 4•Pare+e601 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 Applicant90175- NCS`- Telephone (012- ?1 Z"(0 <br /> Address H-F• t�-+1 l0 Fax <br /> �M U U r1CVs A2._(),) '\N <br /> Interest in Property(check appropriate box) <br /> Owner of Property <br /> a Contract for Deed Owner - <br /> a Lessee,Operator,Manager <br /> a Agreement to Purchase <br /> a 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 /> IIP <br /> Property Description/ProposaI <br /> Address or General Location . 1 S" t t` ( I D <br /> Legal Description <br /> Property Identification#(PIN#) • <br /> #of Acres <br /> Current Zoning <br /> Present Use Type of Application <br /> a UndeveIoped/Vacant t] Comprehensive Plan Amendment $200 <br /> a Single Family Dwelling 0 Rezoning $200/ac;min$200 max$1000 <br /> Duplewo Family Dwelling a Major Subdivision $250+$250 deposit* <br /> a Multi-family Dwellings 0 Minor Subdivision $150 <br /> mss. Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> a Industrial Establishment a PUD Amendment $150 <br /> a Other(explain) o Conditional Use Permit R-I,R-2$75;all others$200 <br /> Variance R-1,R-2$75;all others$200 <br /> a • Code Appeal $75 <br /> 0 Develop Review/Site Plan $100/ac;min$100 max$500 <br /> a Wetland Alteration Permit $50+deposit* <br /> a Wetland Buffer Permit 7 <br /> a Floodplain Permit $200 <br /> • Other <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />