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COMMUNITY DEVELOPMENT DEPARTMENT <br />M0 iCLANNING APPLICATION <br />Mounds View Blvd., Mounds View, MN 55112 <br />(763) 717-4020 * Fax (763) 717-4019 <br />permits@moundsviewmn.org <br />Please Type or Print Information - Complete Both Sides of This Form <br />Applicant Information <br />Name of Applicant r--)Pk F._A ram iz A LEx _ Work # <br />Address_ 9�44i FAiscN1 _Cityl�Dy IpLSt2rte l�llV _2ip�2, <br />Home # 763ZM" 5'—Cell # 10- 45A — 3&4 Fax # E-mail YE <br />Interest in Property �WW. <br />(check appropriate box) nei <br />Downer of Property ❑Contract for Deed Owner ❑Lessee, Operator, Manager <br />Agreement to Purchase ❑Other <br />AppllcantsmustprovldeevldenceolInterestln propertyatthetlmeofappllcatlon, andifyouare <br />not the owner of the property, you must either provide a letter of permisslon from the owner <br />glving consent to the flllng ofthIs applIca tion or the propertyownermcWs/gn th/sapplication for <br />It to be sccepted. <br />Property Description/Proposal <br />Address or General Location <br />Legal Description <br />Property Identification # (PIN #} _ <br /># of Acres Current Zoning <br />Type of Application (Please check the appropriate boxes): <br />Comprehensive Plan Amendment <br />500 <br />Rezoning <br />$500 <br />Subdivision <br />$750 <br />Planned Unit Development (PUD) <br />$750 <br />PUD Amendment <br />$400 <br />Conditional Use Permit/Amendment <br />R-1 R-2 $200; all others T400 <br />Interim Use Permit/Amendment <br />$400 <br />Variance <br />R-1, R-2 $200; all others $400 <br />Administrative Variance <br />R-1, R-2 $100 <br />Text Amendment Zoning Cade <br />$400 <br />_ <br />Text Amendment, Other ClCode <br />300 <br />Develop Review/Site Plan Review <br />$400 <br />R-1, R-2 $200; all others 350 <br />Wetland Alteration Permit <br />Wetland Buffer Permit <br />R-1, R-2 $30; all others $100 <br />Easement Vacation <br />$250 { <br />Re -approval of Minor Subdivision or Plat <br />Minor Subd. $50; Plat $100 <br />Zoning Review of B-1 District Proposed Use <br />$200 1 <br />Page 1 of 2 <br />