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City of Mounds View,MN <br /> Development Application Page 2 <br /> i <br /> Property Classification !40 Abstract a Torrens <br /> Description of Proposal <br /> Pub L t- Po-c& (A-e2Ieffri-u 5 ..e -P-0 0 <br /> L1� V <br /> LL 1 l Lo S ( 74--(3 14 `7 1 oiQ <br /> BY MY(OUR) SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> i4i1OWLEDGE,THE INFORMATION PROVIDED IS TRUE AND AC TE. — • <br /> i <br /> Signature of Applicant � _ f <br /> Name of Applicant(typed/printed) A7/4/( .a Z ,i�4 w r�`�•if <br /> Signature of Prone:ty Owner <br /> Name of Property Owner(typed/printed) <br /> FOR OFFICE USE ONLY <br /> Date of Submittal a.0 t 9,,C) <br /> Date of Acceptance ..;LA.,-2;., 7> C Bev, Rtv idu' :-TA-1-4-i) Assigned to: <br /> Planning Case No. 60-day Limit q/23/q 7 120-day limit Y / z t/4/7 <br /> Fees Pais: account <br /> Application: <br /> Park Dedication: <br /> Deposits: <br /> •Other: <br /> Total: <br /> C:.OFFiCV WPWL`\WPDOCSiADM3N\FOELMS\DEVAPP.FOR 1/97 <br />