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CLITY <br /> �`•�f)' ( COMMUNITY DEVELOPMENT DEPARTMENT <br /> DEVELOPMENT APPLICATION <br /> • <br /> 2401 Highway 10, Mounds View MN 5511 <br /> -‘1'=1'Partner$4 <br /> 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please pe or Print Information-Complete Both Sides of This Form <br /> Applicant Information / <br /> Name of Applicant /�i r( . GI' G Telephone 1.e/a-F 0 /-/ F <br /> •�:,. <br /> Address 0 2-5' 14' S' tir/ Fax <br /> Fax <br /> vi-I)/ A4 N S ' 390 <br /> Interest in Property heck appropriate box) <br /> ❑ Owner of Pr••erty ❑ Contract for Deed Owner <br /> Lessee,Op-Gator,Manager a Agreement to Purchase <br /> ❑ Other(expl ) <br /> Applicants must p vide 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 �n � �S ,�� <br /> Address or General Location /"1 V 5--au a i-a- \ • <br /> Legal Description 67Property Identification#(PIN#) 07 - 30- a-3 — )� — D 0 7 <br /> #of Acres <br /> Current Zo g - <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> ❑ Rezoning $250/acre; min$250 max$1500 <br /> ❑ Major Subdivision $250+$250 deposit* <br /> O 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 /> ❑ Variance R-1, R-2$100 all others$250 <br /> ❑ 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-l,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 /> • <br /> Please complete the reverse side of this application. <br />