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%1� R <br />I�V•' <br />CITY OF MOUNDS VIEW <br />PLANNING APPLICATION <br />' <br />Date.--ja--,';: <br />APPLICANT <br />Name fir/g ��lLSON <br />Phone�l�L <br />/i�11 <br />w� t <br />Addteee'�GS N lb liriL� Li <br />Interest in Property. (check appropriate box): <br />}*;j <br />1. <br />Owner of Record Lessee, Operator, <br />8 <br />Manager <br />} <br />qContractorfor Deed Owner Agreement to <br />Purchase <br />+ <br />Other (Explain) <br />Jr <br />,uired <br />Documentary evidence of applicant' interest in the property <br />may be req <br />before Jinal. City ac'yion�y�-on [lie request y Cy ' " �j4i '• <br />/^ raC Location�j' �L IftLV lb <br />• PROPERTY• Addreeo .,ens <br />x Legal Owner: Name/Address or e ) a <br />rr (/t <br />µ::.-:.Present Use (Check Appropriate,Box) '- <br />Undeveloped/Vacant Apartment <br />ment <br />Business Esablish <br />Single Family Dwelling { <br />Duplex Dwelling Industrial Establishment. ,yy <br />Multiple Dwelling 1('3�-6,^units) <br />' Other (explain) It1/IIL'. CCC.LIi]1)11 l'SFr <br />Property Class if icationt ❑ Abstract 0 Torrena i•y yy <br />REQUEST: (E�plain)07b11�{'r�rn K I �o' k <br />IS <br />I hereby_ declare that the Above statementa are <br />r.' FOR OFFICE USE ONLY: <br />BASE FEES* <br />` Subdivision, Major <br />Subdivision, Minor <br />Rezoning <br />Conditional Use <br />Variance <br />Code Appeal <br />Alteration Permit <br />($150) <br />($15) <br />($50) �cp•0O <br />($50) <br />($50) <br />($50) <br />($50) <br />*Base Fees in parenthesis are non-refundable. <br />t <br />Park Fund Dedication <br />Date Paid <br />Receipt Number <br />ADDITIONAL FEES <br />Reapportionment <br />Public Hearing Notice <br />Staff, Consultant Reviews d <br />Miscellaneous <br />Subtotal <br />TOTAL FEES <br />Date Paid <br />Receipt Number <br />