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For Office Use Only <br /> �T T T.,.� � c Planning Case No. 12' <br /> �1� j�j.LJ Submittal Date <br /> 1245 West Highway 96 Application Completed Date <br /> Arden Hills, Minnesota 55112 Accepted by <br /> Telephone (651) 792-7800 Receipt Number <br /> Fax (651) 634-5137 Council Decision <br /> Council Decision Date <br /> 2012 LAND USE APPLICATION <br /> Applicant Information 1 <br /> Applicant: -T>1 \V Fcw"' -- V K OLD* <br /> Address: S � <br /> Telephone No.: (I-- 19lot & :-R-" Other: <br /> Fax No.: <br /> Email Address: ' ,' <br /> Property Information <br /> Property 0wner: q� �9� <br /> Owner Address: O l O _ <br /> Owner Telephone No.fo51-3�//-�.2(o Other. (, 1~ �� /9 0 <br /> Address of Property Involved: <br /> Legal Description: (Jd � t4 ��` e !' '� <br /> Property iD No.: A4, <br /> Type of Use: SWV. -tc?at j <br /> Property Acreage: <br /> ct <br /> Zone. s / <br /> Type of Request ❑ Planned Unit Development Amendment($600;$300 if <br /> no Site Plan Review is required+$2,000 escrow) <br /> ❑ Comprehensive Plan Amendment($850+$1,000 <br /> escrow) ❑ Site Plan Review($300+$600 escrow) <br /> ❑ Conditional/interim Use Permit or Amendment ❑ Rezoning($600+$1,000 escrow) <br /> ($600; $300 if no Site Plan Review is required ❑ Zoning or City Code Amendment($600+$1,000 <br /> +$600 escrow) escrow) <br /> ❑ Preliminary Plat($600+$25 per lot+$1,500 ❑ Minor Subdivision(lot split/consolidation) ($450+ <br /> escrow) $1,000 escrow) <br /> ❑ Final Plat($500+$25 per lot) Variance(Zoning Code)($300+$600 escrow) <br /> ❑ Concept Planned Unit Development($300) ❑ Vacation of Easement or Right-of-Way($400+$600 <br /> ❑ Master Planned Unit Development($600+$2,000 'escrow) <br /> escrow) ❑ Appeal of Administrative Decision ($100) <br /> ❑ Final Planned Unit Development($300.00+$600 ❑ Land Use Requests—Not Already Specified($200) <br /> escrow) <br /> Revised:12-08-11 <br /> Page 1 of 3 <br />