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tr_1 <br /> il111© ' E? COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICA'flik <br /> �'"' 2401 Highway 10, Mounds View MN 5511. <br /> • nR`"1f-PartnertiQ.' 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 Ali N i-1-Q rt1 =( P,2. p y2 rt e Telephone 9 i - 1'?/ • 47/Lik-L- <br /> Address ].n 7 7 o e 0 1:1, Fax ' 7 Z - /'2/ -"4Y2.,/ <br /> t. .,i-e it10 <br /> O'A'CL A -5 T4 7 sacl <br /> Interest in Property(check appropriate box) <br /> qQOwner of Property ❑ Contract for Deed Owner <br /> Lessee,Operator,Manager a Agreement to Purchase <br /> Q Other(explain) <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 <br /> Ill <br /> Legal Description 5,3'. G A-TTC 144:::-- <br /> Property <br /> L7)Property Identification#(PIN#) <br /> #of Acres <br /> Current Zoning 7 Ll O <br /> Type of Application <br /> Q Comprehensive Plan Amendment $250 <br /> Rezoning $250/acre; min$250 max$1500 <br /> Major Subdivision $250÷$250 deposit* <br /> Q Minor Subdivision $L00 <br /> o Planned Unit Development(PUD) Refer to rezoning fees <br /> a PUD Amendment $350 <br /> a Conditional Use Permit R-1, R-2 S75;all others$250 <br /> a Variance R-1, R-2$100 all others$250 <br /> a Code Appeal $100 <br /> 0 Develop Review/Site Plan 5125/acre;min$125 max$750 <br /> 0 Wetland Alteration Permit R-1,R-2$150;all others$200 <br /> a Wetland Buffer Permit R-1,R-2$25;all others$100 1 <br /> a Floodplain Permit $200 <br /> 0 Other <br /> *Deposits shall be paid to cover ail 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 />