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__ . _ _ .... <br />y _ _ _ <br />�^ _ _. ,. ��,.:.�. � � �.:. �=-- ; _ . _ <br />' _ —L_" _'�__� �___'-..,.�_ __ � __ . �c.___�.: I-�_ _ _ �_ "__ . -.1, � �_. . "_'" <br />A <br />(,�;���,r^i; `,'�� <br />'C� `l�(1j,j{;lr., <br />�_-J�_.,,. c� <br />A <br />A �j C�: j�:� <br />.� <br />I I� 5��.f <br />'�L'rei� , Parinccst`�P�' <br />COMMUNITY DEVELOPM�IV7 DEPARTME�IT <br />PLANNTNG APPLICATICIN <br />2401 County Road 10, Mounds View, MN 55i,12 <br />(763)71i-4D20 <br />Fax(651)765-1660 <br />Pleasz Type or Print Information - Complete 6oth Sides of This Form �,� <br />Appticant Yn�ormation 1 <br />C a. \1 4-=.� �: - � � i: -� - ��-1 � � <br />Idame nf Applicant �1� ��� �/l �' �+��ti'\._4�= �'e-'�1 Telephone ��.� 7`C��'-�� 2�=��� <br />Address `:�C>� �2 1 �� �c- �,���� �` Fax __..---- <br />�>; �.�� � e�:_:_y V1�"���:� -�i`� \ \ Z <br />E-mail: � c.:+7_a� ��c`�� c�� ,..,��� �—��... t'`��' <br />Interest 'in Property (check appropriate box) <br />� Ovdner of Properly <br />O Lessee, Operator, Manager <br />f� Other (expiain)___. <br />❑ Contract for Dezd Owner <br />p Agreement to Purchase <br />App/icants must prnvide evidence of interest in praperfy at the time afapplicati4n, and if <br />you ar� not the owner of the property, you musi either provide a letter ofpermission f�am <br />tlre ownergivinq consent to the filing of this applicativn or the property oivner must sign <br />t/rls app/ication for it to be accepted. <br />Property Description/Proposal <br />Address or General Location <br />Legal Description <br />Property IdentificaYion # (PIf� #) <br /># of Acres <br />Current Zoning <br />Type of Application (Please check the appropriate boxes) <br />