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City of Mounds View,MN <br /> Development Application Page 2 <br /> • <br /> Property Classification lir Abstract a Torrens <br /> Description of Proposal <br /> Pt)n I°L - Co Pre-2 /e +v . 5 1-0-7e_ T1-0 <br /> Ce_ LtO l ti-Lv S &?4--0 / - `74,c <br /> cfre, u r LO( c—(� <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> • <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND ACC ' •TE. <br /> • <br /> Signature of Applicant /� / — <br /> Name of Applicant(typed/printed) /V/¢A��Z = 'rye GO <br /> 1. <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 1.‘V") <br /> Daze of Acceptance v R.t1 Assigned to: <br /> Planning Case No. 6O-day Limit j23/9 7 120-day limit Y t i z.i/ <br /> Fees Paid: Account 4 Cb T T 03 <br /> Application: <br /> Park Dedication: <br /> Deposits: <br /> •theTme <br /> Total: <br /> c:.OFFiczwiPwwwPDOCSIADmimFORmsoEVAPP.FOR li97 <br />