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City of Mounds View,MN <br /> Page 2 <br /> Development Application <br /> • Present Use of Property <br /> ❑ Undeveloped/Vacant 0 Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling X Multi-family Dwelling <br /> ❑ Business/Commercial Establishment 0 Industrial Establishment <br /> ❑ Other(explain) <br /> Property Classification a Abstract 0 Torrens <br /> Description of Proposal () L 1,z <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS I' AND ACCURATE <br /> Signature of Applicant <br /> Name of Applicant(typed/printed) <br /> Qs,C.F1 ney"."1/441"-\-'Y .r Ji n, S. <br /> Signature of Property Owner j#1.- <br /> • Name of Property Owner(typed/printed) <br /> Address of Owner <br /> e)-.� fjiLG ; X. a <br /> Phone Number of Owner n 6 6 6- or- <br /> *** -_***************** <br /> FOR OFFICE USE ONLY <br /> Date of Submittal ¶J"1 Assigned to: <br /> Date of Acceptance Asssignlimit <br /> Planning Case No. 3-7 C ,_ ? 60-day Limit 120-day <br /> Fees Paid: Account# Check# Receipt# <br /> Application: 0-.5 O loo 311(0.1., �� ) 0 5 <br /> Park Dedication: <br /> Deposits: <br /> • Other: <br /> Total: <br /> 1/98 <br /> N:\DATA\GROUPS\COMDEV\FORMS\DEVAPP.FOR <br />