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City of Mounds View. MN ' <br /> Development Application Page 2 <br /> • Present Use of Property <br /> ❑ Undeveloped/Vacant - ❑ Single Family Dwelling <br /> 0 Duplex/Two Family Dwelling 0 Multi-family Dwelling <br /> Fs Business/Commercial Establishment 0 Industrial Establishment <br /> 0 Other(explain) <br /> Property Classification 0 Abstract 0 Torrens <br /> Description of Proposal I ,_), 1-,6,,,.« .f' <br /> ' BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BE ' OF MY.,•'._- _ :44, <br /> KNOWLEDGE,THE INFORMATION PRO I.ED IS <br /> TRUE AND ACC • 'TE. -_ _ . .. .w__ <br /> Signature of Applicant pZ / AIAlr 4k-4r <br /> Name of Applicant(typed/printed) 13'W EL L. IAL/, riMillir ' ' -t <br /> N_:::::,,,,.._ ,,,1 4 <br /> ..., <br /> Signature of Property Owner <br /> -1 I ,-orirAPPr 1° <br /> Name of Property Owner(typed/printed) - '` 1(L L. Aise (_ 1"' ' ! k e P6,_ $-,13 <br /> Address of Owner _ . '2-2•00--u_- t�G (0 _ _ '`'Al — ICICCII\ 1.1 <br /> ttw- ._ <br /> rua,.InM SUu(:&) nm,..) <br /> Phone Number of Owner - -)Ti..)39) - 7V 11 ":6'F 5, <br /> FOR OFFICE USE ONLY <br /> Date of Submittal -I - <br /> Date of Acceptance Assigned to: <br /> Planning Case No. 3 r.- 01 $ 60-day Limit 120-day limit <br /> Fees Paid: Account# Check# Receipt# <br /> Application: ,SO. O V )DO ^ 3 q-o 3 "471 6 9 5'9739 <br /> Park Dedication: <br /> Deposits: <br /> • Other. <br /> Total: <br /> N:'DATA\GROUPS1COMDEV\FORMS\DEVAPP.FOR 1/98 <br />