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05/14/99 15:41 FAX 612 784 3462 CITY OF NV Z003/005 <br /> City of Mounds View,MN Page 2 <br /> Development Applicntioa <br /> Present Use of Property p Single Family Dwelling <br /> • <br /> aUndeveloped/Vacant Duplex/Two Family Dwelling t: Multi-family Dwelling <br /> o Business/Commercial Establishment C Industrial Establishment <br /> O Other(explain) <br /> Property Classification 0 Abstract /111( Tam <br /> Description of Proposal N Et,J CotJs-ctt-L -TI et-5 CSP 4 U.N 1'l. 12.614-47)G Pitereitrp <br /> BY MY(OUR.)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT.TO THE BEST OF MY <br /> KNOWLEDGE.THE INFORMATION PROVIDED IS TRUE ANDD ACCURATE, <br /> Signature of Applicant <br /> Name of Applicant(typed/printed) 1J')cQ e e J udi r <br /> Signature of Property Owner <br /> lile‘44/auName ofPrope ty Owner(typed/printed) ;llae( f. tzr t <br /> Address of <br /> Owner gill Tel- Cocci (',asst r►6 • <br /> - 554 -3 <br /> Phone Number of Owner _fo i 31S " 31rr- Z <br /> *******************************************s***.*.****************************w***************** <br /> FOR OFFICE USE ONLY <br /> Date of Submittal 5-a' —°t <br /> Assigned to: <br /> Date of Acceptance 60-day Limit 120-day Iimit <br /> Planning Case No. S s 9 <br /> Account# Check# Receipt# <br /> Fees Paid: �, <br /> Application: J_i—'0° I£ O- 31 / C?(/ <br /> Park Dedication: <br /> Deposits: <br /> Other: <br /> Total: <br /> ;mss <br /> NADATAIOROUPS1COMDEVFORMSTEVAPP.FOR 411 <br />