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, � <br />Mounds View Pfanning Applica��un ,: � Page 2 <br />��� . �� � : � <br />Prope�°ty Cl�s�ifECa#�on ❑ Abstrac� � Torr�ns <br />(�escri�tson of Propos�f (attach additionaf supporting documentation if necessary) _ <br />,�J �� /� /�,�� ����� � /� __�-�-- �-i ._ _ � ,,,_ _ <br />Please Noice; Applicants are responsibte for alI costs incurred assotlated with the filing, review and processing of this application. <br />Suth fees are to be pa(d In escrow up front or upon receipt af statement from the City of Mounds View. Fees may include but are <br />not limited to costs for consultants retained by the City, consultant pianning services, attorney, and engineer fees, A deposit may <br />also be rec�uired to cover costs of public notices, mater(als and statf time spent in the review, research ar preparation of materials <br />associated with this applieation. The applicant shall be responsibfe for alI reasanable ineurred costs in excess of the inifial deposit <br />amount. Any por�ion of the deposit not spent ar eneumbered shall be refunded to the appiieant within 30 days at�er consideration <br />of the application is completed. Peyrnent of park dedication fees is required with subdivislon applications. <br />I ACKNOWLEDGE 7HAT i have read ail of the Infarmation listed in the Planning Application and ful]y understand that I am <br />responsibfe for�lf-epsts incurred by the Clty re4ated to the proeessing of this applicatian. <br />Applicant <br />� �—/ %`°a'� <br />Date <br />� .� : �. ' f. : .. , , i, >- � . � : <br />��-. .._ �- <br />� : - ; t <br />; i+ . , � . =R ' " �: " ° � <br />� ': �, � , � . �. ; . : a ��,� l �,: i', � •° � <br />Name of App <br />Signature of <br />Name of Property Owner (typed/printed) <br />Signature of ProperLy Owner <br />Address af Owner <br />Phone Number af Own�r _ 7� �3 —� 7� 5-_/.7� �. j <br />E-maif r�h 6 S r`�,,�-c-� C�' _� l� i, ���� <br />�******�*�*�x�***�x**�*�*��x*�**�**���*�x****��*��:****���x���:*��x�*�*�***��******�*�:*�**�***�* <br />Ft�R O�FTCE �BSE OIVLY � <br />uate of Submitta! i� - f�� 0 3_ Date of Aeceptance: ����' ` o <br />60-day Limi� 120-day iimit: <br />�lanning Case No(s) 1('&2� � m c� �� Assigned to: <br />Fees Paid: Aeeount # Check # f Re eipt <br />App(ication: 1 Sd� a� � S � ���Do° �3 S f 1� d <br />park Dedication: <br />Deposits: <br />Other: <br />TotaL• <br />i oioz <br />c� <br />