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City of Mounds View,MN <br /> Development Application Page 2 <br /> 411 Present Use of Property <br /> ❑ Undeveloped/Vacant 0 Single Family Dwelling <br /> ❑ Duplex/Two Family Dwelling 0 Multi-family Dwelling <br /> ❑ Business/Commercial Establishment 0 Industrial Establishment <br /> Other(explain) <br /> Church <br /> Property Classification ❑ Abstract 0 Torrens <br /> Description of Proposal Request permission to add office space and classrnom.G in (kilt= <br /> to ret..- • 10 . .• -.��_ •• •• - - Y•- �I• • -•� - - . -w . • <br /> of develop reviewLsite plan fees for thnGP port.innc of 1-hP prnparty that are <br /> within the heavily wooded/flood 7n Q-Al1.,Lwat}and area (appox. 3 acres) <br /> BY MY(OUR)SIGNATURE ON THIS APPLICATION,I HEREBY DECLARE THAT,TO THE BEST OF MY <br /> KNOWLEDGE,THE INFORMATION PROVIDED IS TRUE AND CCURATE. <br /> Signature of Applicant �t � <br /> Name of Applicant(typed/printed) Carey Lyo <br /> II) Signature of Property Owner • <br /> Name of Property Owner(typed/printed) Sunrise United Methodist Church <br /> Address of Owner 7687 Long Lake Road <br /> Mounds View, MN 55112 <br /> Phone Number of Owner 786-4926 <br /> ************************************************************************************************ <br /> FOR OFFICE USE ONLY <br /> Date of Submittal /2 - -°l 7 <br /> Date of Acceptance Assigned to: <br /> Planning Case No. - CA-p)60-day Limit 120-day limit <br /> Co>e--1 <br /> Fees Paid: Account# Check# Receipt# <br /> Application: S/ 'AD iD I341(0,4 • L t 5 7 49 3 'Uta <br /> Park Dedication: <br /> Deposits: <br /> • Other: <br /> Total: <br /> N:\DATA\GROUPS\COMDEV\FORMS\DEVAPP.FOR 1/98 <br />