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p 1.pgateciico>,` <br />PLANNING CASE NO. 212-87 <br />CITY OF MOUNDS VIEW <br />PLANNING APPLICATION <br />1 APPLICANT: Name <br />Add <br />Interest In Property (cheek appropriate box): <br />Owner of Record <br />Contractor For Deed Owner <br />Other (Explain) <br />RE -APPLICATION OF CASE <br />NO. 67-80 (11/ 4/P 0) <br />Date / "X L <br />Phone 6 6'2 - �2 <br />Lessee, Operator, Manager <br />Agreement to Purchase <br />Documentary evidence nF applicant's interest in the property may be required <br />before final City action on this request. <br />PROPERTY: Address/General Location fs :SIP <br />Legal Owner: Name/AddressI <br />Present Use (Check Appropriate Box): <br />Undeveloped/Vacant Apartment <br />Single Family Dwelling Rosiness Esablishment <br />Duplex Dwelling, Industrial Establishment <br />Multiple Dwelling (7-6 unite) <br />Other (explain) <br />Property Classification: P Abstract ❑ Torrens <br />REQUEST: <br />I hereby declare that the above statements are <br />gnature) <br />FOR OFFICE USE ONLY: <br />BASE FEES* <br />ADDITIONAL FEES <br />Sohdivlsion, Major <br />($150) <br />Reapportionment <br />Subdivision, Minor <br />($75) —00 <br />Pohllc llearting Notices <br />Rezoning <br />($50) <br />Staff, Consultant Reviews <br />Condltlonni Use <br />($50) <br />Miscellaneous <br />Variance <br />($50) <br />Code Appeal <br />($50) <br />Alteration Permit <br />($50) <br />*Anne Fees In pnrenthesta <br />are non-refundnble. <br />Subtotal <br />Park Food Dedication <br />TOTAL FEES <br />Date Paid-- <br />hate Paid -F7 <br />Receipt Number <br />—_// <br />Receipt Number d @�(F <br />