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CITY OF <br /> OU OO COMMUNITY DEVELOPMENT DEPARTME4110 <br /> -s DEVELOPMENT APPLICATI <br /> onr: 2401 Highway 10, Mounds View MN 55112 <br /> O.pu, <br /> -gyp <br /> -ParrnelS ' 612-717-4020 <br /> 612-784-3462 -FAX <br /> Please Type or Print Information-Complete Both Sides of This Form 4 <br /> Applicant Information <br /> Name of Applicant r n1/ S(� /LI Telephone 7 g <br /> /1 <br /> Address go l? f , -t (l O 1r► J`.G� Fax <br /> 4 L,rtd Ut ct�✓ <br /> • <br /> Interest in Property(check appropriate box) <br /> Owner of Property 0 Contract for Deed Owner <br /> O 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 7 � � � �� � L <br /> Address or General Location 26 L' U'ii e J P- 10 <br /> Legal Description Se e S C ( "Z. <br /> Pro Identification# PIN# C O O'1 I '0t-a C's 3O -- <br /> PAY ( ) 5 3 a-3 / fl � <br /> #of Acres <br /> Current Zoning R 3 <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 /> 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-I,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, • <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 atter consideration of the application is completed. <br /> Please complete the reverse side of this application. <br />