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City of Mounds View, MN <br /> Develo•ment A. •lication <br /> Pa e2 <br /> Present Use of Property . <br /> ❑ Undeveloped/Vacant •'/ 2 Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling ❑ <br /> ❑ Business/Commercial Establishment 0 Multi-family Dwshing <br /> Industria!E <br /> 0 Other(explain) stablishment <br /> Property Classification 0 Abstract R Torrens <br /> Description of Proposal To subdivirp the property in to two lots. One with <br /> the existing 1'IonGp anti nnp fnr riPvP1 npmpni- <br /> • <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) ntTA NE R. PETERSON — <br /> CY PETERSON <br /> Signature of Property Owner 411 <br /> - _--- - <br /> Name ofPro <br /> P�YOwner(typed/printed) nrnu R_ PP-TFR4nN - ANCY/ <br /> ETERSON. <br /> _. <br /> Address of Owner <br /> ---_ .-___. . . -------- <br /> 91Q <br /> S MAT)TSnN <br /> -TSANTT, MINNESOTA_ 55040 <br /> Phone Number of Owner (F 1 2) 444-A4FR <br /> • <br /> FOR OFFICE USE ONLY <br /> Date of Submittal -2° _Ol <br /> Date of Acceptance <br /> Planning Case No, Ss Assigned to: <br /> 7 - 9 60-dav Limit 120-day limit <br /> • <br /> Fees Paid: • Account Check# <br /> Application: ; ,j Da Receipt <br /> 1 <br /> Park Dedication: 7 'c?S c'l� <br /> Deposits: <br /> Other: • <br /> Total: <br /> N:\DATA\GROUPSICOMDEV\FOR,MS1DE VAPP.FOR <br /> L98 <br />