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City of Mounds View,MN <br /> Development Application tr. Page 2 <br /> Present Use of Property <br /> a Undeveloped/VacantSingle Family Dwelling . • <br /> a Duplex/Two Family Dwelling a Multi-family Dwelling <br /> ❑ Business/Commercial Establishment 0 Industrial Establishment <br /> a Other(explain) <br /> Property Classification ; Abstract a Torrens <br /> Description of Proposal e ..o.s rr 'Lc) e - .0 n'' . J i I- e c A e x - <br /> 4- 7 cl ,- r-7.4 , --,.. ,.../:)-.' 1/ f-- e°;.e C__k_3°/jci/5, t'l 7, ;-'2,/ Af-F,/,.. ' .' ts <br /> d- ! - .aci cf G J-7--) Jd7L /l av,e - cti.S` P t-a r 0 2 <br /> r.e,40-F 01ti $ w Ck_ f( d- V :-y p f cz� e ice, /c)o/c cam. . <br /> 5 c. e V c;)tca x•p1c- r‘ c .�/' C/r' - <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDE S Ty AND A' CURATE. <br /> , <br /> Signature of Applicant <br /> IAl <br /> Name of Applicant(typed/printed) ,...1 01-7 r) n , j (1 <br /> Signature of Property e ice,/ ' <br /> Name of Property Owner(typed/printed) , -j(--) 't') t/y2 <br /> Address of Owner 8 3 R e d Ori. W 01 r <br /> Phone Number of Owner 9 c c' — 7' 7L -2 <br /> ************************* * ************************************ <br /> FQR OFFICE USE ONLY <br /> Date of Submittal r rl --- Lt <br /> CI1 <br /> Date of Acceptance '7 T t'- 1 `1.qAssigned to: d IAA" <br /> Planning Case No. to --q'rt 60-day Limit 120-day limit <br /> Fees Paid: Account# Check# Receipt# <br /> Application: 41/ 0 O ' /C 0 a '-t — S7A 3 3oura <br /> Park Dedication: <br /> Deposits: <br /> Other: • <br /> Total: <br /> 1/98 <br /> N:\DATA\GROUPS\COMDEV\FORMS\DE VAPP.FOR <br />