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Development Application
t� x City of Oak Park Heights 14168 Oak Park Blvd N. •Oak Park Heights, MN 55082 •Phone(651)439-4439 • Fax(651)439-0574 CoAA, ,.1;34\,.3Ln Pit Development Application G)I4 08,C9' Type of Request(s): p ._ ❑ Zoning District Amendment 0 Home Occupation ,g1 Conditional Use Permit COJ 11MA AA- 0 Site Plan/Design Guidelines Review ❑ Variance: Single Family Residential ❑ PUD Amendment ❑ Variance: Other Residential/Commercial 0 PUD Concept Plan Approval /Industrial 0 PUD General Plan Approval ❑ Subdivision: Major 0 Street Vacationekb fly ❑ Subdivision: Minor 0 City Financial Assistance <6_i i-2- ❑ Comprehensive Plan Amendment COA '3Z `�, Id> 1 Ct Base Fee: M UC, Escrow Amount: 4 I, coo ` Street Location (Address)of Property: 41(9c raC k QA CMC DO-Ak '44LiT k tl) LOTS ELEVEN(11),TWELVE(12)AND THIRTEEN(13),EXCEPT THE NORTHERLY Legal Description of Property:_SEVENTEEN AND SEVENTY-FIVE HUNDREDTHS(17.75)FEET OF SAID LOT THIRTEEN (13),ALL IN BLOCK NINETEEN(19),ELFELUES ADDITION TO OAK PARK, ACCORDING TO THE PLAT THEREOF ON FILE AND OF RE Block 19 Lot 11 ELFELTS ADDITION TO OAK PARK This Property Is 1 Abstract 0 Torrens(Certificate#) Property Identification Number(PIN, PID): , ©3 t. at• 3 3 - 41-! 3 OWNER INFORMATION ((�� Name: li,Ci IR�b 1, . --�c�YUY�S 6 N Address: Street: Ip P 9.cj 0-4 City: SI`\ t1o(I A State: MSS Zip: S— 8'. Email: 0_4-0 1 d S3-0 2 0 av i •CDx1 Telephone: Home:1;c/-7,7,9-9a bb Business: Fax: Other: (I &SI '4513 -gegg" APPLICANT INFORMATION Name: 0_,G et) Address: Street: le 1 iP .tb I City: i ;ky State: tk`U Zip: Ski 2'. Email: 0_331*051 A SSbga Ca)) Oi-C(>41 Telephone: Homeic1_ 112?-cil ,o Business: Fax: Other4.Sl 53 ('7 (( Owner/Applicant Initials a z I l (� ` �.1)_u..cl (Lipp1 �s 3 (/,2\ 111 City of Oak Park Heights 14168 Oak Park Blvd N. •Oak Park Heights,MN 55082 • Phone(651)439-4439 • Fax(651)439-0574 Development Application Page 2 Description of Request(s):. Z..2- a)(../iii 6.0+ A CI-We SnYci -- .c 0\ - If a request for planningThning action on the subject site or any part thereof has been previously approved, please describe below: , G.i a• .111.4 4. 11 GENERAL CONDITIONS Application Review: The undersigned acknowledges that before this request can be considered and/or approved, all required information and fees, including any deposits shall be paid to the City. An incomplete application will be returned to the applicant. The application approval process commences and an application is considered complete when all required information and fees have been submitted appropriately to the City. Professional Fee Responsibility: It is the understanding of the undersigned that all City incurred professional fees and expenses associated with the processing of this request(s)will be promptly paid upon receipt. 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. Applicants will be billed on a monthly basis for Planning, Engineering, Legal and Community Development fees as they are accrued. It is understood that interest will be charged on the account at the maximum rate allowed by the Fair Credit Act if it becomes thirty (30) days past due. Failure to pay administrative and processing fees in a timely manner may result in denial of the application. All fees must be paid at the time of the application and shall be paid prior to the issuance of a building permit. The undersigned applicant further acknowledges and consents that all unpaid fees owing the City of Oak Park Heights shall be treated as unpaid utility fees and may be certified for collection as with delinquent utility billings and may be assesses against the subject real property if unpaid by October 31"of each year. Property Address: Owner Signature: l„Q11 . A--c„...\01,_16„, Date: O ' - II - ol.bn Applicant Signature: tilc 1\X\ .rive Date: 0-Z- II -,164D