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41=GI <br /> GUNGUNN COMYLMUNTTY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> el :.,..,,. <br /> v v 2401 Highway 10, Mounds View MN 55112 <br /> yrs-Parnit(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 a ..0-v�'yc [1 J_ ,sC,e3`1 Telephone lQ U Lc — 7"7 7J <br /> Address `a c�2 ,-e V`. 4LCJY\ Fax (0(I (0 - $CQ l <br /> 1 Oc)c £ 1,-'s 5 - d- <br /> 5\- .P mn ry 5sLaTs- )./19 <br /> Interest in Property(check appropriate box) <br /> a Owner of Property <br /> a Contract for Deed Owner <br /> GK., 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 /> litroperty owner must sign this application for it to be accepted. <br /> party Description/Proposal h� <br /> Address or General Location c,3 G/ 4 Ea wuc� 1J <br /> e/ 'Lc. -u <br /> Legal Description <br /> Property Identification#(PIN#) <br /> #of Acres <br /> Current Zoning 13 —3 <br /> Present Use Type of Application <br /> • .. .ills .{..,.1s•• , Amenament $200 <br /> a Single Family Dwelling a Rezoning 5200/ac;min$200 max S 1000 <br /> a Duplex/Two Family Dwelling 0 Major Subdivision $250+$250 deposit* <br /> Q / Multi-family Dwellings 0 Mnor Subdivision $150 <br /> Business/Commercial Establishment 0 Planned Unit Development(PUD) $350 <br /> O Industrial Establishment 0 PUD Amendment $150 <br /> O Other(explain) Conditional Use Permit R-1,R-2 S75;all oth ) <br /> a Variance R-1,R-2 S75;all others$200 <br /> O Code Appeal S75 <br /> a Develop Review/Site Plan $100/ac;min$100 max$500 <br /> a Wetland Alteration Permit $50+deposit* <br /> O Wetland Buffer Permit ? <br /> a Floodplain Permit $200 <br /> O Other <br /> • <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />