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I1 %!l' Z; COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> • ... <br /> if V'Ft 2401 Highway 10, Mounds View MN 55112 <br /> nRMl'-Partne" 612-717-4020 <br /> 612-784-3462 - FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information n <br /> Name of Applicant D a vt ,2..+-C. s Telephone 6),P - 9 gf'h-S7 3 <br /> Address S Z u e_.V‘1.-�, IDI\ Fax <br /> . S.S'» . . <br /> Interest in Property(check appropriate box) <br /> X Owner of Property 0 Contract for Deed Owner _ <br /> 0 Lessee, Operator,Manager a Agreement to Purchase <br /> ❑ 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 I ' <br /> . • Address or General Location <br /> 6\- r,, 6—S `" e 1 t-g „� .. <br /> Legal Description Lv T 2k. igLK • (z Pi (7eweocd' 72,dvgce 4-`-/ <br /> ,,Property Identification#(PIN#) -', ' <br /> _ <br /> #of Acres <br /> Current Zoning '9 — J <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment 5250 <br /> ❑ Rezoning 5250/acre; min 5250 max$1500 <br /> ❑ Major Subdivision $250+S250 deposit* <br /> 0 Minor Subdivision $200 <br /> 0 Planned Unit Development(PUD) Refer to rezoning fees <br /> 0 PUD Amendment $350 <br /> a Conditional Use Permit R-1, R-2 S75;all others$250 <br /> _Variance R-1, R-2 5100 all others 5250 <br /> 0 Code Appeal $100 <br /> a Develop Review/Site Plan 5125/acre;min S125 max$750 <br /> 0 Wetland Alteration Permit R-1,R-2 SI50;all others 5200 <br /> ❑ Wetland Buffer Permit R-1,R-2 S25;all others$100 <br /> a Floodplain Permit 5200 <br /> 0 Other <br /> *Deposits shall be paid to cover all costs of public notices,materials and staff or consultant time spent in the review, <br /> • <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 after consideration of the application is completed. <br /> Please complete the reverse side of this application. <br />