Agenda Packets - 2023/10/09 - Laserfiche WebLink

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Application fees are non-refundable. Present Use of Property Dental clinic and administrative offices Property Classification Abstract ❑ I orrens Description of Proposal (attach additional supporting documentation if necessary) Expansion of parking lot to provide an additional 20 parking stalls BY MY/OUR SIGNATURE ON THIS APPLICATION, I HEREBY DECLARE THAT, TO THE BEST OF MY KNOWLEDGE, THE INFORMATION PROVIDED IS TRUE AND ACCURATE, Please Note: Application fees are nonrefundable. Applicants are responsible for all costs in excess of the application fee incurred by the City in the processing of this application. Such excess fees are to be paid upon receipt of statement from the City of Mounds View. Excess fees may include, but shall not be limited to, photocopy costs, staff time, and fees for planning consultants, attorneys and engineers. In some cases, a deposit may be required in advance to cover any anticipated excess costs associated with this application. (If a deposit is required, the applicant shall remain responsible for all reasonable incurred costs in excess of the application fee and deposit amount.) I ACKNOWLEDGE THAT I have read all of the information listed in the Planning Application and fully understand that I am responsible for all costs incurred by the City related to the processing of this application. Name of Applicant (tyf Signature of Applicant Name of Property Own Signature of Property Owner Address of Owner 2442 R CEO Phone Number of Owner (763) 754-5780 E-mail of Owner mheetreedental.org FOR OFFICE USE ONLY: Date of Submittal _ 60-day Limit Planning Case No(s) Fees Paid: Application: Park Dedication: Deposits: Other: Total: Vi Date of Acceptance: 120-day limit: Assigned to: Account # Check/Credit # Receipt # Page 2 of 2