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yeti <br /> IMIMS COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> °t nrWRIT42401 Highway 10, Mounds View MN 55112 ip <br /> -,. <br /> 6I2-784-3055 <br /> .�`-P"`t`�'��Y <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information —7 3 —j <br /> Name of Applicant :51E4.J+= A510-) LA - t- -"`'f Z Telephone <br /> Address e41 G p ' <br /> YACVS W-2 t_.L� Fax <br /> NY-Lrd3v i-v t,v, ,�.t"i n r\eSc'l 4- <br /> S-C11 <br /> 4-SC11 Z. <br /> kt--est in Property(chock-vt„opriute box) <br /> Owner of Property <br /> a Contract for Deed Owner <br /> a Lessee,Operator,Manager 1 l Y\ 11 <br /> a Agreement toai Purchase <br /> a Other(explain) 04v-1 O-a 3 -Q-01 - 00 1 B <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 /> Property Description/Proposal rn n` �c-A IIIP <br /> Address or General Location `;'mak" - � loir ace c-.scx-i bpi. as (t4 taws . Ct Q.tl�. <br /> +h-e. Iior*hut e_s r Com(nom• o Sack. `Q-� 321• y �. ey 6 J_ <br /> L D tion r)•r 39 q_ s c e_ 0E- 3-t S --rte. } the Q d t n7' F b eej�nr.�.n5. <br /> Legal °� ` � L �qS L erg aux�� c� \I�ne. pa-ta\ke� to - �. (v�-;h' <br /> Prop I carton TN <br /> 1'r` ,;c1. ? q &-5 `c_e, of Q.\1 +c -e-4 ,ne_e.. -rK.crti aim G <br /> 4 of Acres p -)1.O .a— , . = .c._...- '{'\ Line 0 -c- <br /> Cutrent nmg S t . Io r .31q, • -1-{`2v'- --C- ui e%-i eci y )v'- ' - �t ert d 1%.,(\e, o±i- c '-5 <br /> . d iS c - ..-. CA % % Fe`s-a-t- Te 4i,.€ w C.Sr 1;n e' 01' Cwt- 38 3 4i-... c--e, _ 13:3(--.44-‘ dr- <br /> e . a,v..k 0-1- fx ru.� Agra 1 Zf3 .5vbdcv;SO4 <br /> �`c�n n� w e S�r �n� cam- l o jr 3� e of Apphca on <br /> Present Use <br /> Uadeve of scant m 5�`-1 CC'a� M:n a Cotnprehensive Plan Amendment S200 <br /> a Single Family Dwelling a Rezoning SZ00iac;min$200 max 51000 <br /> a Duple:uTwo Family Dwelling " c Major Subdivision 5250:5250 deposit* <br /> a Multi-family Dwellings Minor Subdivision 5150 <br /> a BusinessiCommercial Establishment c Planned Unit Development(PUD) 5350 <br /> a <br /> Industrial Establishment a PUD Amendment 5150 • <br /> C Other(=plain) a Conditional Use Permit R-I,R-2 7 5;all others 5200 <br /> Variance R.-I,R-`Feil others 5200 <br /> a Code Appeal S75 • <br /> Develop ReviewiSite Plan S100/ac;min 5100 max 3500 <br /> C Wetland Alteration Permit S50+deposit' <br /> e We Jird Huffer Permit 7 <br /> C FioodniainPermit 5200 <br /> a other <br /> • <br /> 'see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />