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City of Mounds View,MN <br /> Development Application <br /> Page 2 <br /> Present Use of Property <br /> • ❑ Undeveloped/Vacant ❑ .'Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling ❑ ' Multi-family Dwelling <br /> 't. Business/Commercial Establishment ❑ Industrial Establishment <br /> ❑ Other(explain) <br /> Property Classification ❑ Abstract ❑ - To• _..rrens -- <br /> .. <br /> Description of Proposal A-11N 7- L_/ /E S -b EK S Z J. (`3O 1.-t14.A0 <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATIONPROVIDED IS TRUE AND ACCURATE. --------- <br /> Signature of Applicant �- -2-'"--_ .,-._( ._ _.. . .< _�, ,,:...- _ <br /> Name of A Applicant(typed/printed) JI61_ Li- L-L, ,;_.: <br /> .... .. . .. __ .-..rf' i 3-/«J.. c u .::'•� .�wD1 -.Hin-'.Zu ..wt.v. t/,Y..i.' <br /> .1 <br /> O ...-,.-•,....-;=-•:•,.,1--;.::•- -,----•-• - � - 1 <br /> Signature of Property <br /> 401.ame of Property Owner(typed/print <br /> Address of Owner . . _ <br /> _ ! U( o^ 3 LAI - <br /> Phone Number of Owner w )N. 7 5 9 - 1- 2i l C <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 1,'—/7 - 9 <br /> Date of Acceptance Assigned to: <br /> Planning Case No. 5a 3- a c 60-day Limit 120-day limit <br /> Fees Paid: • Account# <br /> Check# Receipt# <br /> Application: /5 O. p0 <br /> Park Dedication: <br /> n!et 3 R 6,2SS � <br /> Deposits: <br /> Oplier: <br /> Total: <br /> N:IDATA‘GROUPSICOMDVAFORMSZE VAPP.FOR <br /> 1/98 <br />