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City of Mounds View,MN <br /> Development Application Page 2 <br /> • <br /> Property Classification 0 Abstract `f Torrens <br /> • <br /> Description of Proposal <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> IGNOWT.FT)GE,THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br /> Signature of Applicant ..-y1 <br /> Name of Applicant(typed/printed) (. <br /> • <br /> Signarnre of Property Owner �a �n-L- <br /> Name of Property Owner(typed/printed) • <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 09 - 1 6'-4 7 <br /> Date of Acceptance 07 - i co - 7 Assigned to: <br /> Planning Case No. 4- c1 La- q 7 60-day Limit a- -1-c i 120-day limit i t- 3 -q <br /> Fees Paid Account Check# <br /> Application: <br /> Park Dedication: <br /> Deposits: <br /> Other-. • <br /> Total: <br /> C:.OFFICEIWPWNIWPDOCS1ADMIV1FORMSIDEVAPP.FOR 1/97 <br />