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COMMUNITY DEVELOPMENT DEPARTMENT <br />MOUN-Di'S' <br />VWE-W2401 <br />PLANNING 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^iz A kz Work # <br />Address i�1444t FAi6:5=BjLD Ac - - City l i �iE4 State-N Ijzip� —. <br />Home # 763 - M- 5116 Cell #_ rjk 3- 4M -- Fax # E-mail*6 <br />Interest in Property ate_ <br />ne4 <br />(check appropriate box) <br />❑Owner of Property ❑Contract for Deed Owner ❑Lessee, Operator, Manager <br />Agreement to Purchase ❑Other <br />Appllcantsmustprovldeev/denceof/nterestlnpropertyatthetlmeofappllcatlon,andlfyouare <br />not the owner of the property, you must eltherprov/de a letter ofpermission from the owner <br />givingconsfsnt to the filingofthlsappllcation orthep%ppadyownermi stsign thIsapplication for <br />It to be accepted. <br />Property Description/Proposal Address or General Location M41 Fhe__-N WD AVEMD N2l t_ Y 1r <br />[ Q.) 4 551 L2 <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 />___ <br />$400 <br />Conditional Use Permit/Amendment <br />R-1, R-2 $200; all others 400 <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 Code <br />$400 <br />Text Amendment, Other City Code <br />$300 <br />Develop Review/Site Plan Review <br />$400 <br />Wetland Alteration Permit <br />R-1, R-2 $200; all others $350 <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 <br />Page 1 of 2 <br />