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Cr;GI <br /> II 1O !OUNDO COlYEVITTNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> 2401 Highway 10, Mounds View MN 55112 qp <br /> hrntcstY' 612-734-3055 <br /> 612-784-3462-FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information <br /> Name of Applicant U� l L4eW r r ilk''- 1 l4? Telephone, 1-(13"-. <br /> 3 5 Sl�} <br /> 4 <br /> Address IA CO l l+ lt d aer . Fax `/T e 3 5-60 4/2-- <br /> S ort,2. t/I v`t - <br /> Interest in Property(check appropriate box) <br /> E2 Owner of Property <br /> yX Contract for Deed Owner <br /> a Lessee,Operator,Manager <br /> a 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 letter of permission from the owner giving consent to the filing of this application. The <br /> property owner mint sign this application for it to be accepted. <br /> • <br /> Property Description/Proposal ( ) �,g <br /> Addressor General Location . w `--+-' <br /> Legal Description P - rune( <br /> • Property Identification#(PIN#) <br /> of Acres 12 • 3 S t <br /> C:ureat Zoning [� Z ( PO e el) ) <br /> Present Use Type of Application <br /> a Undeveloped/Vacant a Comprehensive Plaa Amendment S200 <br /> Single Family Dwelling c Rezoning • •• • 5200 max 51000 <br /> a Duplex/Two Family Dwelling Major Subdivision S-251 - �..I •r.. <br /> Multi-family Dwellings a Minor Subdivision <br /> a Business/Commercial Establishment c Planned Unit Development(PUD) 5350 <br /> Industrial Establishment a PUD Amendment 5150 <br /> Other(explain) a Conditional Use Permit R-1,R-2 575;all others 5200 <br /> a Variance R-1,R-2 S75;ail others 5200 <br /> a Code Appeal S75 <br /> A Develop Review/Site Plan S I00/ac;min 5100 •• 5500 <br /> a Wetland Alteration Pit 550 deposit" <br /> c Wetland Buffer Permit ? <br /> a Floodplain Permit 5200 <br /> a Other <br /> *see Municipal Code for explanation of deposits <br /> Please complete the reverse side of this application. <br />