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,t <br /> 11 1© r COIYEVITINTIT DEVELOPMENT DEPARTMENT <br /> 1. DEVELOPMENT APPLICATION <br /> -: ,7z <br /> ;.:e..,.:?./ 2401 Highway 10, Mounds View MN 55112 ', <br /> •P4, - <br /> t•Patau ly 612-784-3055 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information <br /> ' ' / � <br /> Name of Applicant �1 U/ El l eW t reo <br /> e-if41 ' 1 T-4L ,, Telephone 3^S-578 <br /> / <br /> Address F 1•4(O L 1 t`�'Cr2 �t ( - . Fax q e 3 `5- ,0'1 — <br /> Interest in Property(check appiopriate box) <br /> a Owner of Property <br /> yX Contract for Deed Owner <br /> a Lessee,Operator,Manager <br /> c Agreement to Purchase <br /> a 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 Ietter 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 ID �" � � • i <br /> Addressor General Location .Lo <br /> F-f'Ct w t I"t�,/ �� '(� <br /> _Legal Descipdon ic'k t. - n Loer <br /> • Property Identification#(PIN#) <br /> #of Aces l • c3O t <br /> C;ureat Zoning a-Z ( Pu 0 rpc , <br /> Present Use Type of Application <br /> C Undeveloped/Vacant a Comprehensive Plan Amendment S200 <br /> C Single Family Dwelling c Rezoning "•a ..• S200 max 51000 <br /> a Dupl wo Family Dweilino X Major Subdivision 5251 - I •r-e•-- <br /> a Multi-family Dwellings a lrfmor Subdivision <br /> a Business/Commercial Establishment a Planned Unit Development(PUD) S350 <br /> a Industrial Establishment a PUD Arnerrirrrnr 5150 <br /> a. Other(explain) C Conditional Use Permit R-1,R-2 S75;all others S200 <br /> a Variance R-1,R-2 575;all others 5200 <br /> a Code Appeal 575 <br /> A Develop Review/Site Plan S l00/ac;min 5100 5500 <br /> C Wetland Alteration Permit 550 deposit* <br /> C Wetmiri BtuTer Permit ? <br /> a Floodplain Permit 5200 <br /> C Other S <br /> 'see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />