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,n, .w <br /> �s , .(i? <br /> ,i_.,,,,,,-. <br /> < <br /> >j l> _ COMMUNITY DEVELOPMENT DEPARTMENT <br /> III ... <br /> DEVELOPMENT APPLICATION <br /> "_"` 2401 Highway 10, Mounds View MN 55112 <br /> °14'4•PartntrS4' 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 �_ � , Telephone (la- ,S -ib) <br /> Address ((,4 —fl -,('1 T ( Q t Ti41 . Fax to I2— '&54-, 3t-'' <br /> G/t-rol r : 1 grit- <<iri3EF-r <br /> ALOorn1Ni( a►.), mNJ 55Gtg5 <br /> • <br /> Interest in Property(check appropriate box) <br /> ❑ Owner of Property \ ❑ Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager "Cl 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 /> 410 Property Description/Proposal � ' I <br /> Address or General Location ; C1. <br /> Z° .5 -�L t,J& 1(; , (Y\Cj u.N1S \J`Ed <br /> Legal Description <br /> Property Identification#(P1N#) e", Lt 3,o-; ?3 ( -- 0-raq_.`j <br /> #of Acres <br /> Current Zoning 6 <br /> Type of Application <br /> ❑ Comprehensive Plan Amendment $250 <br /> a Rezoning $250/acre; min$250 max$1500 <br /> o Major Subdivision $250+$250 deposit* <br /> o Minor Subdivision . $200 <br /> ❑ Planned Unit Developmet(PUD) Refer to rezoning fees <br /> \❑ PUD Amendment $350 <br /> Conditional Use Permit R-1, R-2$75;all others$250 <br /> a Variance R-1, R-2$100 all others$250 <br /> a Code Appeal $100 <br /> o Develop Review/Site Plan $125/acre;min$125 max$750 <br /> ❑ Wetland Alteration Permit R-1,R-2$150;all others$200 <br /> a Wetland Buffer Permit R-1,R-2$25;all others$100 <br /> a 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 />