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City of Mounds View,NEN <br /> Development Application Page 2 <br /> • <br /> Property Classification a Abstract 0 Torrens <br /> Description of Proposal <br /> • <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I IEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND ACCURATE. <br /> Signature of Applicant • <br /> Name of Applicant(typed/printed) <br /> Signature of Property Owner <br /> Name of Property Owner(typed/printed) <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal / — r{.- q 7 <br /> Date of:Acceptance Assigned to: <br /> Plinnirigg Case No. c-c, q _ q 60-day Limit 120-day Limit <br /> Fees Paid: Account T Check T <br /> Application: -7 5 a 0 / 0(7 _1, <br /> Park Dedication: <br /> ( <br /> Deposits: S-7o <br /> Other: • <br /> Total: <br /> C:.OFFC .wP`NWWPDOCSVOMIN FOILMS1DEVAPP.FOR li97 <br />