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• <br /> City of Mounds View,MN I: . <br /> Development Application Page 2 <br /> • Present Use of Property <br /> a Undeveloped/Vacant X Single Family Dwelling <br /> C Duplex/Two Family Dwelling ❑ Multi-family Dwelling <br /> ❑ Business/Commercial Establishment ❑ Industrial Establishment <br /> ❑ Other(explain) <br /> Property Classification X Abstract ❑ Torrens <br /> Description of Proposal 0 2. (r . .y .• --. / - r' -I' ' f/ <br /> bit c k 4x t ."0,,/,,, , . 1,0 y` j eiIP iv,kr e.7> izso/. iuet.ifirQyd 7�y ; ff �idr'�7Arr17 Nr* ms.,/, T�1�t,7 /7.- s--l /yilr e Y}.rt 1C_ /17-- <br /> I/I" <br /> /fT <br /> I/I" Qr 41/.J �,l, <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION.I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PRO VIDEDIS TRUE AND <br /> Signature of Applicant 2�,r r-2�%/ (moi/.i,22�-/ <br /> Name of Applicant(typed/printed) tv"i,_.11 t/ bt)' L./ /' . <br /> • Signature of Property Owner <br /> Name of Property Owner(typed/printed) 7—Tin Q 4' /12 4/`j/' <br /> Address of Owner A 41' e fP)174W1 AYP, <br /> gDzed.S. J 1 /4/l/ SS'/l2- <br /> Phone Number of Owner 64:2 ' ,g y— ,9.. 'I 71 <br /> Date of Submittal <br /> 4 FQR FICE USE ONLY 7 _ .. . <br /> Date of Acceptance Assigned to: <br /> Pl;inning Case No. S33. Ai, 60-day Limit 120-day limit <br /> Fees Paid: Account# Check# Receipt# <br /> Application: 100•0e tOJ-34=' - 7 -2 t r) i,5-I <br /> Park Dedication: <br /> Deposits: <br /> • Other: <br /> Total: <br /> N:1DATA\GROUPS\COMDEV\FORMS\DEVAPP.FOR I/gg <br />