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anry Cr:: <br /> 'OU WOO COMMUNITY DEVELOPMENT DEPARTMENT <br /> • DEVELOPMENT APPLICATION <br /> ; 2401 Highway 10, Mounds View MN 55112 <br /> ,n'rf':t-partners''''''' 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 Q U h t1 // <br /> f7 f'I / �'1 Telephone 2 r96 7 S c <br /> Address g3 <5/ . !ti e-4 0 cL/ Df i U e Fax <br /> i U CA ✓vI (LS V/ /0 lV <br /> Interest in Property(check appropriate box) <br /> Owner of Property ❑ Contract for Deed Owner <br /> ❑ Lessee,Operator,Manager 0 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 9 R ej 0 1e 0 r J' v e <br /> Legal Description /°t10 /JO O ni es t~.«d /7c-tC?- Bic e-, l `- 104- 4 <br /> Property Identification#(PIN#) C36v 3 C .3 / 0 10 0 <br /> #of Acres JO 4- 2 9. S /r c 3 <br /> Current Zoning R -5; d' n ii ci <br /> Type of Application <br /> o Comprehensive Plan Amendment $250 <br /> o Rezoning $250/acre; min$250 max$1500 <br /> a Major-Subdivision $250+$250 deposit* <br /> O Minor Subdivision $200 <br /> o Planned Unit Development(PUD) Refer to rezoning fees <br /> o PUD Amendment $350 <br /> o Conditional Use Permit R-1, 2 all others$250 <br /> .-'' r`"" Variance R-1, )11 others$250 <br /> ❑ Code Appeal $100 <br /> o Develop Review/Site Plan - $125/acre;min$125 max$750 <br /> o Wetland.Alteration Permit R-1,R-2$150;all others$200 <br /> o Wetland Buffer Permit R-1,R-2$25;all others$100 <br /> O Floodplain Permit $200 <br /> o Other <br /> • <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 />