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1 <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> • '` DEVELOPMENT APPLICATION <br /> 2401 Highway 10, Mounds View MN 55112 <br /> die"t,-r,r«els$1.4.' 612-717-4020 <br /> 612-784-3462 -FAX <br /> / Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information / / r / / <br /> Name of Applicant /'�jG1,az �IferA?d' Zen// Telephone(6;i2.. 475 0 3`i 71 <br /> Address '73 S6 /`q:ekal 4c Fax <br /> /41 oft4,K.0/a. , <br /> Interest in Property(check appropriate box) <br /> XOwner of Property 0 Contract for Deed Owner <br /> ❑ Lessee, Operator,Manager ❑ 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 3 86' !D 1 V%..?Anl 1 y� <br /> Legal Description ` O+ l(7 ( i k I Si j u N Lake woo 4 <br /> Property Identification#(PIN#) Or? —30 — )-3 —13- 0©5 Cs -- y <br /> #of Acres <br /> Current Zoning <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> ❑ Rezoning $250/acre; min$250 max$1500 <br /> ❑ Major Subdivision $250+$250 deposit* <br /> ❑ Minor Subdivision $200 <br /> ❑ Planned Unit Development(PUD) Refer to rezoning fees <br /> ❑ PUD Amendment $350 <br /> ❑ Conditional Use Permit R-1, R-2$75;all others$250 <br /> X. (Variance;: R-1, R-2$100 all others$250 <br /> 0 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 /> ❑ 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 />