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QTV OF <br />©N1, L <br />A <br />�W <br />rOBrP,f - Parinersh`QS <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />PLANNING APPLICATION <br />2401 County Road 10, Mounds View, MN 55112 <br />(763)717-4020 <br />Fax —/1;-)) %1 I - HON <br />Please Type or Print Information - Complete Both Sides of This Form <br />1 <br />jz@G1_�4EC) <br />Applicant Informa/tion M.t <br />Name of Applicant Work # <br />Address N ` ti Home# �Q a'�1V3 1b'�;G <br />in \cr \;v 3-Sk7)'y Cell# (.o -`}(o l0`�Q, <br />E-mail: <br />Interest in Property (check appropriate box) <br />Owner of Property ❑ <br />❑ Lessee, Operator, Manager ❑ <br />❑ Other(exDlain) <br />Contract for Deed Owner <br />Agreement to Purchase <br />Applicants must provide evidence of interest in propertyat the time of application, and if <br />you are not the owner of the property, you must either provide a fetter ofpermission from <br />the owner giving consent to the fling of this application or the property owner must sign <br />this application for it to be accepted, <br />Property Description/ Proposal <br />Address or General Location g40u \� <br />Legal Description <br />Property Identification # (PIN # <br /># of Acres <br /><�!)S 30 z3 3 i C)c>cS__ <br />..1 .O-' Current Zoning 63 <br />Type of Application (Please check the appropriate boxes): <br />Comprehensive Plan Amendment <br />500 <br />Rezoning <br />500 <br />Major Subdivision <br />500 <br />Minor Subdivision <br />275 <br />Planned Unit Development PUD <br />750 <br />PUD Amendment <br />375 <br />Conditional Use Permit Amendment <br />R-1 R 2 <br />150' all others 375 <br />Interim Use Permit Amendment <br />375 <br />Variance <br />R-1 R-2 <br />150; all others 375 <br />Administrative Variance <br />R-1 R-2 <br />75 <br />Text Amendment Zoning Code <br />250 <br />Text Amendment Other City Code <br />150 <br />Develop Review Site Plan Review <br />375 <br />Wetland Alteration Permit <br />R-1 R-2 <br />150• all others 300 <br />Wetland Buffer Permit <br />R-1 R-2 <br />25• all others 100 <br />Other <br />Page 1 of 2 <br />