2013-5-23 Development Permit ApplicationJJ�,h
A.1bertAffe
RECEIVED STAAAF
■ DEVELOPMENT PERMIT APPLICATION
5975 Main Ave NE
P.O. Box 9
Albertville, MN 55301-0009
(763) 497-3384 fax (763) 497-3210
Case No: r. o� 3- ot'�
Base Fee:_ qtp-0'-�)
Escrow Amt: l -APd. t5 Ca3
Date Filed:0S-tA 3-L�
Please read carefully and answer all questions thoroughly. Only complete applications will be
accepted after validation by the City Clerk and prior to acceptance of required processing
fees/deposits.
Type of Request(s):
Zoning
Site and Building Plan Review
Comprehensive Plan
Zoning Text Amendment
Rezoning
Variance
Conditional Use Permit
Interim Use Permit
PUD Concept Plan
PUD Rezoning or PUD/CUP
Subdivision
_ X Minor Subdivision/Consolidation
Preliminary Plat
Final Plat
Subdivision Grading Plan
Other
STAFF MEETING DATE: PLANNING COMMISSION DATE:
PROJECT PLANS DUE DATE: CITY COUNCIL DATE:
Address of Subject Property: 1CZ7:> �L.p,�4,g L_v K\,E-
Name of Business:
Legal Description of Property (attach additional sheet if necessary):
Lot: zi—t ! �0
Block Plat#
Subdivision:
PID#
Current Zoning Classification (circle): Al
A2 R1-A R1 R2 R3 R4 R5 R6 R7 R8 RMH
B2
B2-A 3 B4 BW 11 12 P/I
Owner: Name.
is
Address. S
City. %c
State. A4' Zip. S
Telephone .763-U0.1l�f4Business)?(o3-Z�j/•
?,i (Fax) -2 !-
Applicant (If other than the owner):
Owner: Name.
Address.
City.
State. Zip.
Telephone (Home).
(Business) (Fax)
Description of Request(s): ,�,,s�Vff V �F` ��z f1. i so y V-V-r - „
EFFECTS OF THE PROPOSED USE: List impacts the proposed use will have on property in
the vicinity, including, but not limited to traffic, noise, light, smoke/odor, parking, and describe
the steps taken to mitigate or eliminate the impacts: /LLB-_-ti�, �S
Reason Why Request Should Be Granted:
Existing Use of the Property / Nature of Facility or Business: I A.U-,
If a request for planning/zoning action on the subject site or any part thereof has been
previously sought, please describe it below:
What?
When?
Project Name, if applicable:
I hereby apply for the above consideration and declare that the information and materials
submitted with this application are in compliance with City Ordinance and Policy Requirements
and are complete and accurate to the best of my knowledge.
I understand that the application will be processed for the next available meeting agenda after
review of the information submitted to determine if any other data is needed and after
completion of a staff report.
I understand that all City incurred professional fees and expenses associated with the
processing of this request are the responsibility of the property owner and/or applicant and
should be promptly paid. If payment is not received from the applicant, the property owner
acknowledges and agrees to be responsible for the unpaid fee balance either by direct payment
or a special assessment against the property. If the property fee owner is not the applicant, the
applicant must provide written authorization by the owner to make application.
Signature(s) of Owner(s):
Signature of Applicant(s):
Approved _ Denied by the Planning Commission on:
Approved _ Denied by the City Council on:
Date:
Date:
Date:
Date:
Date:
Date:
Distribution
City Planner: Building/Zoning Official: Fire Dept.:
City Engineer: Public Work/Parks: Other:
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