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rPLICANT: <br />r <br />CITY OF MOUNDS VIEW <br />PLANNING APPLICATION <br />Date l•./•�•��` <br />Phone 7b (• %%C1 <br />Address r�'•J%� j' JY r l'i --- — `, <br />Interest in Property (check appropriate box): <br />Owner of Record Lessee, Operator, Managcr <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 final City action on this request. <br />PROPERTY: Address/General Location �•��� LC/� <br />REQUEST: <br />Legal Owner: Name/Address M06 l d I X1-IXiTc}. <br />Present Use (Check Appropriate Box): <br />Undeveloped/Vacant <br />Single Family Dwelling <br />Duplex Dwelling <br />Multiple Dwelling (3-6 units) <br />Other (explain) <br />Property Classification: <br />Is <br />Apartment <br />Business Esablishment <br />Industrial Establishment <br />❑ Abstract ❑ Torrens <br />{I r., ,alllllnn,+� _lllrc: fr•r Pi'hic� burl Ini. <br />•I II E. ,1�'c J(-J el -. n 1 - ., ,, I I- cl - - 1U` J <br />I hereby declare that the above statements are true. _ <br />FOR OFFICE USE ONLY: <br />BASE FEES* <br />Subdivision, Major ($150) <br />Subdivision, Minor ($75) <br />Rezoning ($50) •� <br />Conditional Use ($50) <br />Variance ($50) <br />Code Appeal ($50) <br />Alteration Permit ($50) <br />*Rase Fees in parenthesis are non-refundable. <br />Park Fund dedication <br />Date raid <br />Receipt Number <br />ADDITIONAL ADDITIONAL FEES <br />sat. L%p CI=P <br />r <br />fture) <br />--------------------- <br />Reapportionment <br />Public llearting Notices <br />Staff, Consultant Reviews <br />Miscellaneous _ <br />Subtotal <br />'ftl'1'AL PEES <br />Date Paid <br />Receipt Number <br />