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APPLICANT: <br />CITY OF MOUNDS VIEW <br />PLANNING APPLICATION <br />Address <br />Interest in Property (Check Appropriate Blank): <br />_ Owner of Record <br />Contractor for Deed Owner <br />_ Other (Expl ain)_ <br />Date /o _/�_ 9 / Phone ?JO-3S9T(L <br />Lessee, Operator, Manager <br />_ Agreement to Purchase <br />Documentary evidence of applicant's interest <br />in the <br />property <br />may be required <br />before final City action on this request. <br />''// <br />PROPERTY: Address/General Location D B KV7o <br />1/G/UJ <br />UJ�. <br />Legal Owner: Name/Address <br />Present Use (Check Appropriate Blank): <br />Undeveloped/Vacant <br />Singl a Family Dwell ing <br />_ Dupl ex Dwell ing <br />Mul tipl a Dwelling (3-6 units) <br />_ Other (explain) <br />Apartment <br />_ Business Esablishment <br />Industrial Establishment <br />Property Classification: Abstract Torrens <br />REQUEST: (Expl ain) <br />I hereby declare that the above statements are true. Ch.I <br />sign <br />------------------------------------------------------------------------ <br />FOR OFFICE USE ONLY: <br />TOTAL BASE *(Base Fees are Non -Refundable) <br />DEPOSIT FEES <br />Subdivision, Major <br />$250 <br />($150) <br />Subdivision, Minor <br />$100 <br />($75) <br />Rezoning <br />$100 <br />($50) <br />Conditional Use <br />$100 <br />($5U) <br />Variance <br />$75 <br />(550) <br />Code ;appeal <br />$100 <br />(550) <br />7�.Alteration Permit <br />S15U <br />(S5U) <br />an Review <br />S1UU <br />(S50) <br />her <br />($5U) <br />TOTAL FEES PAID i a.00 <br />Date Paid <br />Receipt Number <br />Park Fund Dedication <br />Date Paid <br />Receipt Number <br />Addt'l Fees Paid <br />Date Paid <br />Receipt Number <br />i&te <br />