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`,77 Cf <br /> ©QM De COMMUNITY DEVELOPMENT DEPARTMEN <br /> -2 DEVELOPMENT APPLICATI <br /> i ? 2401 Highway 10, Mounds View MN 5511 <br /> f°`.1.$1•Partner$`1' 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form <br /> Applicant Information '. <br /> Name of Applicant �IIC��G4-n.f' d C -i%4 i /�Grl ok Telephone 60-a — <br /> Address a`.60( 9 oci,(� 11- Fax <br /> WOU►NQS f MA) SSf(a. <br /> Interest in Property(check appropriate box) <br /> Owner of Property ❑ Contract for Deed Owner <br /> ❑ 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 /� �'n <br /> Address or General Location a 8 0( io�,di~cte k_ O v t t--Q • <br /> Legal Description Lai U `LYc'e/4 e?Sn -pt `FLawe of ((461(r,, Q Pavk <br /> Property Identification#(PIN#) k x"331 n C) <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 /> ❑ anance R-1, R-2$100 all others$250 <br /> • Code ppeal • $100 <br /> ❑ Develop Review/Site Plan $125/acre;min$125 max$750 <br /> a 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, II <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 /> 100 — 3C((e 5 <br />