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1 <br />Mounds View Pfanning Application <br />Present llse af P�°op�rt� . �.�.� � <br />Psap�r�yy Cla�sa�`ECat�o� ? Abstract ? Torrens <br />Deser'i�tom� af �ro�os�l {attach additionai supporting documentation if necessary) <br />w <br />;.. ,. � ; .. <br />Page � <br />Please IVote: Applicants are responsibfe for all costs incurred associated with the filing, review and processing of this applfcation. <br />5uch Pees are to be paid in escrow up fronk or upon receipt of statement from the City of Mounds View. �ees may Inc€ude but are <br />not limited to costs for Consuitants retained by the City, mnsultant p3anning services, attorney, and engineer fees. A deposlt may <br />also be required to cover costs of public notices, materials and staff time spent in tfie review, research or preparation of materials <br />associated wiYh this application. The appiicant shall be responsible for all reasonable Incurred costs in excess af the initiai deposit <br />amounY. Any portion of the deposit not spent or encumbered shall be refunded to the appiicant within 30 days after consideration <br />of the application is completed. Payment o€ park dedlcation fees is required with subdivision applications. <br />EDGE THAT I have rea f! of the information listed in the Planning Applicat3on and fully understand that I am <br />for alI costs incurr y the ity related to tfie pro�essing of this application. <br />P .��� ���� <br />Date <br />, t. � ti �s : � � � :t� <br />._ �,5.,. ,� � ; , �' . <br />_, __ . <br />, .- � ; <br />. � � � �.... .. � � ,�, :. � _.; <br />— ,�� , — .� _ �`_ ' �' i �, y" j; ' <br />Name of App <br />Signature of <br />Name of Properly Owner (ty� <br />Signature of Property Owner <br />Address of Owrter $ � � <br />Phone Number of �wner� <br />E-maiE � t°� <br />� � _a a � � <br />� f� _ <br />� ..✓� <br />� � �` � � � -� �� <br />. <br />. �-. : ., . �- . ..- .r . . <br />� �. <br />�_ _a c,_ _ <br />**����K�k****** * yF * * **#�k* �k�K* * �K* 7K �K�K*�*****�k �K�k�kW�k* �K*���I=*�K***���K�*%k�K�K��k�k**�kyk%k�k=k*�k #�K �K �K�K�=* �k * �K** * <br />FCSR OFFICE �1SE Of��.Y <br />Date of Submittal .3°3 i �D�^ Date of Aeceptance: <br />60-day Limit 120-day limit: <br />Planning Case No(s) Assigned to: <br />Applicafiion; <br />Park Dedication: <br />Deposits: <br />Other: <br />TotaL• <br />���-�, <br />� �,P �. . <br />�� �.v @ <br />'n�v- �1�.� <br />Fees Paid <br />�-�� . � <br />.��a{-�.� <br />-� � � c� -� <br />Account # <br />l� ��3�i��I <br />. a <br />Ch�ek # <br />� �� 5 ��� <br />Receipt # <br />�aroz <br />;(J-� � ���.�L�� <br />�f35t�� <br />