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m,. <br /> i;n• u X12:• <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> • DEVELOPMENT APPLICATION <br /> • <br /> 2401 Highway 10, Mounds View MN 55112 <br /> -Partne(sti4' 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 PP A/ C1/4 5 13 z.-:"AlTelephone 7 g c9) <br /> Address. d // 6''1,/N N'y S J R'l> Fax <br /> 1\l/) w'A/OS' 1.1 e 1v /7it( <br /> ''s11 � <br /> Interest in Property(check appropriate box) <br /> Owner of Property ❑ Contract for Deed Owner <br /> o Lessee,Operator,Manager ❑ 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 g // cS 1/A/H'y c5-7 ,t ) <br /> Legal Description ,�L-P 1_ I 02-- <br /> Property <br /> LProperty Identification#(PIN#) O Li? 3 o x311 'D `f ^ooO <br /> r if Acres ' N G G ' 5 L L v(11.t.� <br /> Current Zoning 12., to S <br /> • <br /> • <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 /> a Planned Unit Development(PUD) Refer to rezoning fees <br /> ❑- PUD Amendment $350 <br /> S. 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-1,R-2$25;all others$100 <br /> a Floodplain Permit $200 <br /> ❑ Other <br /> ip *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 />