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C11rif 001F <br />WHO <br />A <br />pgrPrr • PartneR�i�Qs <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />PLANNING APPLICATION <br />2401 County Road 10, Mounds View, MN 55112 <br />(763)717-4020 <br />Fax `/!>� 717-HOR <br />Please Type or Print Information - Complete Both Sides of This Form <br />�zrrciey�a <br />Applicant Information My j <br />Name of Applicant e'_;i n4 NA\ 4 Work # <br />Address �111Co L� `� v� iJv� N Home# 1Q%actto3 1U`�;G <br />LQ�Yvl \��,�Vw:5S10A- Cell# (oke-��(o3 <br />E-mail: <br />Interest in Property (check appropriate box) <br />Owner of Property ❑ <br />�10Lessee, Operator, Manager ❑ <br />❑ Other (explain) <br />Contract for Deed Owner <br />Agreement to Purchase <br />Applicants must provide evidence of interest in property at the time of application, and if <br />you are not the owner of the property, you must either provide a letter ofpermission from <br />the owner giving consent to the riling 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 �Lkr;c�) , \- <br />Legal Description ,� .'tz-y5 <br />Property Identification # (PIN #) 68 3U Z -_'5 3i (50C-' <br /># of Acres --2 , &S Current Zoning <br />Type of Application (Please check the appropriate boxes): <br />Com rehensive 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 />