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C'PLICANT: <br />CITY OF MOUNDS VIEW <br />PLANNING APPLICATION <br />Name <br />Addr <br />Date 1,7/7-1 <br />—T--i <br />Interest in Property (check appropriate box): <br />Owner of Record Lessee, Operator, Manager <br />Contractor for Deed Owner Agreement to Purchase <br />Other (Explain) <br />Documentary evidence of applicant's interest In the property may be required <br />before flaal City action on this request. <br />PROPERTY: Add rees/General <br />REQUEST: <br />Legal Owner: Name/Address UAA4/C . )Lr,16 !A'��__ <br />Present Use (Check Appropriate Box): <br />Undeveloped/Vacant <br />Single Family Dwelling <br />Duplex Dwelling <br />Multiple Dwelling (3-6 unity) <br />Other (explain) <br />Apartment <br />Business Eeabl lahment <br />Industrial Establishment <br />Property Classification: ❑ Abattacr �X_Torrens <br />(Explain) OfVftOP-)f —> A61�)fa. — <br />I hereby declare that the above statements are true.�y _ Y <br />U (aig ture) <br />FOR OFFICE. USE ONLY: <br />BASE FEES* <br />Subdivision, Major <br />Subdivision, Minor <br />Razuning <br />Conditional Use <br />Variance <br />Code Appeal <br />Alteration Permit <br />($150) <br />($75) <br />($50) <br />($50) SU — <br />($50) S7_ <br />($50) <br />($50) <br />t*Bane Fees in parenthesis are non—refundable. <br />Park Fund Dedication <br />Date Paid <br />Recelpt Number <br />ADDITIONAL FEES <br />Reapportionment _ <br />Public llearting Noticee _ <br />Staff, Consultant Reviews 200 <br />Miscellaneous <br />Subtotal <br />TOTAL FEES <br />Date Paid <br />Receipt Number <br />