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City of Mounds View,MN , <br /> Development Application Page 2 <br /> Present Use of Property III <br /> ❑ Undeveloped/Vacant IA Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling a Multi-family Dwelling <br /> ❑ Business/Commercial Establishment 0 Industrial Establishment <br /> 0 Other(explain) <br /> Property Classification 0 AbstractilacTorrens <br /> Description of Proposal Aid,/" /91494411,00'/ 9xi440 r ,heict..47Ac yy471,- G'btfELS <br /> a t gt" fc2,20p b y Ag IJ roe <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I tit,:y DEC • ' THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS ,Lo ' AND ACAS •TE. <br /> Signature of Applicant - 1' , ell <br /> • <br /> Name of Applicant(typed/printed) o/v,1zt • ,4 iv)i 1' <br /> IIISignature of Property Owner r m ,�. <br /> Name of Property Owner(typed/printed) fj o r„104 t <br /> Address of Owner ._. .....___ :`7gsg - a„f:, 0.� . <br /> .. ... �1!//11•✓ ist1 if). <br /> Phone Number of Owner 1.0 . <br /> ************************************************************************************************ <br /> FOR OFFICE USE ONLY <br /> Date of Submittal c1-17 - 9 g <br /> Date of Acceptance Assigned to: <br /> Planning Case No. 60-day Limit 120-dav limit <br /> Fees Paid: • Account# Check# R ei t <br /> Application: l Ts.e, o /2+' tO <br /> Paris Dedication: <br /> Deposits: <br /> Other. . <br /> Total: <br /> N:IDATA\GROUPS\COMDEVWORMS.DEVAPP.FOR 1198 <br />