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sa spa,aha <br /> �J v �d <br /> r <br /> DEVELOPMENT DEPARTMENT <br /> III =... <br /> ..,_, �. DEVELOPMENT APPLICATION <br /> •, 1' • <br /> "'! 2401 Highway 10, Mounds View MN 55112 <br /> oi",1•11 <br /> -p.„,,e, 4. 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information �— <br /> Name of Applicant l'SCP t' J CA) -1=t-013 Telephone *SG (=g 4e3 <br /> Address 1_024 \J J b Fax <br /> • <br /> ” -jt.}N1 tiF. t tiln3 it Z <br /> Interest in Property(check appropriate box) <br /> XOwner of Property ❑ Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager ❑ Agreement to Purchase <br /> ❑ Other(explain) <br /> • <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 must sign this application for it to be accepted. _ ._. - <br /> Property Description/Proposal „.;.• <br /> • Address or General Location Set 244 k-a P,- zj e. jv,.,Ds� z i�� 1 t Z <br /> Legal Description_ o u.-,..:3 cob :' '5 • . <br /> Property Identification#(PIN#) ©•74-- 3o 2...3 - 3 I o o 4z <br /> #of Acres 0 • 84 <br /> Current Zoning R j <br /> Type of Application - <br /> ❑ Comprehensive Plan Amendment S250 <br /> Q Rezoning S250/acre; min 5250 max 51500 <br /> ❑ Major Subdivision 5250+5250 deposit* <br /> ❑ Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) Refer to rezoning fees <br /> ❑ PUD Amendment S350 <br /> ❑ Conditional Use Permit R-1, R-2$75;all others$250 <br /> X Variance R-1, R-2 S I00 all others$250 <br /> ❑ Code Appeal 5100 <br /> ❑ Develop Review/Site Plan - 5125/acre;min$125 max$750 <br /> ❑ Wetland Alteration Permit R-1,R-2 5150;all others$200 <br /> ❑ Weiland Buffer Permit R-1,R-2 S25;all others 5100 <br /> 0 Floodplain Permit $200 <br /> ❑ Other <br /> • *Deposits shall be paid to cover all costs of public notices,materials and staff or consultant time spent in the review, <br /> research or preparation of materials associated with this application. The applicant shall be responsible for all reasonable <br /> incurred costs in excess of the initial deposit amount. Any portion of the deposit not spent or encumbered shall be refunded <br /> to the applicant within thirty(30)days atter consideration of the application is completed <br /> Please complete the reverse side of this application. <br />