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Cr!e1 <br /> [flfl1i11eigiNEZ COM ItTNTTY DEVELOPMENT DEPARTMENT <br /> • v DEVELOPMENT APPLICATION <br /> :I:Well-NT <br /> Highway 10, Mounds View MN 55112 <br /> *",-p.rovsn"'ti 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information <br /> i <br /> Name of Applicant AT/h o„i,/„66 FOpi-rurA,l Telephone GI2. e `7'-`/35,5 <br /> Address /2-40 w — 57 So.Tx goo Fax <br /> 71-1.,oM r,u(,it»0, Ali. icil/ <br /> Interest in Property(check appropriate box) <br /> Ar Owner of Property <br /> O Contract for Deed Owner <br /> a Lessee, Operator,Manager <br /> O 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 /> roperty owner must sign this application for it to be accepted. <br /> Des ri <br /> ropertyc ' <br /> ptrott/Proposal <br /> Address or General Location Spm ; f4411 �1raLle t1 .7 0/ /olc:-V, . /0 <br /> Legal Description Loi / L tai vc.e. 3, Prvyr‘.m,,.v.4 L.0-.tic( P rs4-4 h- . <br /> Property Identification#(Pt.N 0;;3e 3 0 7,S - KN - 000.•--1 <br /> of Acres 5O1001 Szt. r-(.• 1 { a-ore <br /> Current Zoning B -3 't <br /> I -ka.1 1.,A•ti 5 i ,n e45 1J,S L.. <br /> • <br /> Present Use Type of Application <br /> a Undeveloped/Vacant 0 Comprehensive Plan Amendment $200 <br /> 0 Single Family Dwelling a Rezoning 5200/ac;min$200 max 51000 <br /> • 0 Duplex/Two Family Dwelling 0 Major Subdivision $250 i-$250 deposit* <br /> O Multi-family Dwellings a Minor Subdivision $150 <br /> Business/Commercial Establishment a Planned Unit Development(PUD) $350 <br /> C Industrial Establishment rt PUD Amendment S150 <br /> C Other(explain) Conditional Use Permit R-1,R-2 S75;all others$200 <br /> a Variance R-I,R-2$75;all others 5200 <br /> O Code Appeal $75 <br /> J1( Develop Review/Site Plan $100/ac;min S100 max$500 <br /> O Wetland Alteration Permit $50+deposit* <br /> O Wetland Butler Permit ? <br /> a Floodplain Permit $200 <br /> • C <br /> Other <br /> • <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />