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Jan 27 09 05:38p Wagstaff Management 559-582-4910 p.2 <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />PLANNING APPLICATION <br />2401 County Road 10, Mounds View, MN 55112 <br />J (763) 717-4020 <br />F lDerE"'PartncYt�F` Fax 763 yl7-`l01� <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant <br />Name of .Apl <br />Address <br />E-mail: <br />#555 OadaSS <br />r <br />Interest in Property (check appropriate box) <br />13 Contract for Deed Owner <br />Owner of Properly <br />�] Lessee, Operator, Manager <br />❑ Agreement to Purchase <br />❑ Other (explain) <br />Applicants mustprpvide evidence ofi,7tere.Ft in property at the time ofappfication, andif <br />you are not the owner Df the property, you must either provide a letter of permission from <br />Nae owner giving consent to the filing of this application or the property ownermust sign <br />this appficallon forit to be accepted. <br />Property Description/ Proposal <br />Address or General ! ocation _ <br />Legal Description <br />Property Identification # (PIN <br />r os Acres <br />Current Zoning <br />Type of AF-"-'" rofm�cn rhPrk rhe aoorooriate boxes): <br />5s 11 a <br />?aae I o <br />