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COMMUNITY DEVELOPMENT DEPARTMENT <br />M0U__T_*WtSvvMW <br />PLANNING APPLICATION <br />2401 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 ApplicantWork # aA 9 11 3$1 Z- <br />Address _170,2 �.ff'i(�hSLy et City &M%6A State -.r-D Zip 3709 <br />Home # <br />Cell # M �6_11 3SSl�LFax # <br />A0 1 6" 1 D L rsi-t.r►a:l- Cn� <br />(check appropriate box) <br />21owner of Property <br />❑Agreement to Purchase <br />❑Contract for Deed Owner <br />❑ Other <br />E-mail <br />Interest in Property <br />❑Lessee, Operator, Manager <br />Applicantsm ustpro vide a vidence ofinterestin propertyatthe time ofapplication, andifyouare <br />not the owner of the property, you must eitherprovide a letter ofpermission from the owner <br />giwng consent to the fiiingofthisapplication or thepropertyownermustsign this application for <br />it to be accepted. <br />Property Description/Proposal <br />Address or General Location <br />Legal Description <br />Property Identification # (PIN <br /># of Acres <br />Current Zoning <br />Type of Application (Please check the appropriate boxes): <br />Application Type <br />Fee <br />Escrow <br />Comprehensive Plan Amendment <br />500 <br />$1,500 - $10,000 <br />Rezoning <br />500 <br />$1,500 - $10,000 <br />Subdivision <br />750 <br />$1,500 - 110,000 <br />Planned Unit Development PUD <br />750 <br />$1,500 - $10,000 <br />PUD Amendment <br />400 <br />$1,500 - $10,000 <br />Conditional Use Permit/Amendment <br />R-1 R-2 200• all others 400 <br />$1,500 - $10,000 <br />Interim Use Permit/Amendment <br />400 <br />$1,500 - $10,000 <br />Variance <br />R-1 R-2 200• all others 400 <br />$1,500 - $10,000 <br />Administrative Variance <br />R-1 R-2 100 <br />$1,500 - $10,000 <br />Text Amendment Zoning Code <br />400 <br />$1,500 - $10,000 <br />Text Amendment Other City Code <br />300 <br />$1,500 - $10,000 <br />Develop Review Site Plan Review <br />400 <br />$1,500 - $10,000 <br />Wetland Alteration Permit <br />R-1 R-2 200• all others 350 <br />$1,500 - $10,000 <br />Wetland Buffer Permit <br />R-1 R-2 30• all others 100 <br />$1,500 - $10,000 <br />Easement Vacation <br />250 <br />$1,500 - $10,000 <br />Re -approval of Minor Subdivision or Plat <br />Minor Subd. 50• Plat 100 <br />1 500 - 10 000 <br />ZoningReview of B-1 District Proposed Use <br />200 <br />1 500 - $10,000 <br />