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?1WDZI COMMUNITY DEVELOPMENT DEPARTMENT <br /> • • DEVELOPMENT APPLICATION <br /> ; 'fu 2401 Highway 10, Mounds View MN 55112 <br /> °�*':t-Partners'`'' 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information �+ ` —7 <br /> Name of Applicant �0 ini q 11 kr) P-S-I(J Telephone(ell. l (e. .3-0 0 0-2 <br /> Address 52 0-2-- RA\-/t-.,-,,0 (...it A U. ✓� Fax <br /> U'rrl 0 e-4 v'\cis U 4-14J ley)ir,. <br /> Interest in Property(check appropriate box) <br /> ) <br /> Owner of Property ❑ Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager 0 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 <br /> • Address or General Location �i 3o 2 ✓;.A M c,v N ✓s v E <br /> Legal Description t -r 12 1 B v- I N e.a s 1-4 A rJ 3...s 4 A a. t-T-i o,.l <br /> Property Identification#(PIN#) C>3 3 0 2-3 i W C O 1'Z <br /> #of Acres i?,; G 0 0 (. , 3o A cc-2e <br /> Current Zoning a- 2 , Tw c F'4‘,41L.-i, �s t‘ E--r--s-r--1 A L <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> o Rezoning $250/acre; min$250 max$1500 <br /> o Major Subdivision $250+$250 deposit* <br /> O Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) Refer to rezoning fees <br /> O PUD Amendment $350 <br /> \, 0Conditional Use Permit R-I, R-2$75;all others$250 <br /> NCp Variance R-1, R-2$100 all others$250 <br /> O Code Appeal • $100 <br /> ❑ Develop Review/Site Plan $125/acre;min$125 max$750 • <br /> ❑ Wetland Alteration Permit R-1,R-2$150;all others$200 <br /> ❑ Wetland Buffer Permit R-1,R-2$25;all others$100 <br /> o Floodplain Permit $200 <br /> ❑ Other <br /> *Deposits shall be paid to cover all 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 after consideration of the application is completed. <br /> Please complete the reverse side of this application. <br />