Laserfiche WebLink
City of Mounds View,MN <br /> Development Application <br /> Page 2 <br /> Present Use of Property <br /> a Undeveloped/Vacant X' Single Family Dwelling • <br /> ❑ Duplex/Two Family Dwelling a Multi-family Dwelling <br /> ❑ Business/Commercial Establishment a Industrial Establishment <br /> ❑ Other(explain) <br /> Property Classification a Abstract a Torrens <br /> Description of Proposal ¶t.Q Dir Tot, ©R- Qom. tom)E ..) Arr <br /> ��z •. <br /> '114 r• 1�?t=� ►-1'A..n P •�hS ice- LtT t,�j t„1 <br /> V- i- %._ Gt 12.4.w3rS* Tim la, f�i►-Z�S�f7. <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY 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). 1?,n s — 7004.3 D V eilari ohz <br /> • <br /> Address of Owner__ „_ 'moa¢ • <br /> - t..N.z \jte,) R cN `5S'1 I Z <br /> Phone Number of Owner — (. 27 b o • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 14-A 3_q <br /> • <br /> Date of Acceptance <br /> Planning Case No. y Assigned to: <br /> �7 60-day Limit 120-day limit <br /> Fees Paid Account# Check# Receipt# <br /> Application: ) OO. 00 <br /> Park Dedication: <br /> Deposits: <br /> Other: • <br /> Total: <br /> N:\DATA\GROUPS1COMDEVTORIAS\DEVAPP.FOR <br /> 1198 <br />