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09/23/04 THU 12:41 FAX
Q 003/005
7C:IT OAK PARK HEIGHTS + DEVELOPMENT APPLICATION
VIAVAOM*
ESt AMOV1J'c' � L � o0 �°
141 Oak Park Boulevard Base Fee-
P,O, Box 2007 Escrow Amount: ��, �
Oak Park Hei MN 55062
( 651) 439-4439 Fax: ( 651 ) 439-0574
Street Looation of Property ..���/ .tJ��1s ��
Le Description of Property x %1-��� �� � 5 �� � ���'/ �i� �/c,� �C�,G�i.S
_, c�s�TIC��
Y Owner: Name 4
Add res S: h5d �V �� � � /T� ���.� �• l� �!'!�/J2..���
Cit d�� / � 1J State: zip: �oC / -�7lCo
Telephone: {Hom� (Bus ines:a) i_��_�!L A�?1_16
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{ Fax ) c'/'2- -�C (Other) e;IT7
Applicant: Name �-t�C�� �a1���� -" �'���� ���«��
Address: co M Q r=L � �U l 91oO
State: P :
Cit 0 Zi I's 14 0
CELL Telephone: 4 4effie)&MjjqjL_?joi ( Business) sal=VTO
(Fax} (Other)
T of Re
Zonin District Amendment Home Occupation
Conditional Use Permit �_ Site Plan Review
Variance: Sin Famil Residential PUD: Amendment
Variance-_ Other Residential/Commercial/industrial PUD'. Concept Plan
Subdivision PUD: General Plan
Subdivision: Minor Street Vacation
Comprehensive Plan Amendment Cit Financial Assistance
Description of Re s):
O�A 6ES
If a re for planningizoning action on the subjoct site or an part thereof has been
previousl approved, please describe it below:
Ow ner/Applicant Initials
r ��
09/23/`04 THU 12:41 FAX
Development Application, Pa 2
General Conditions
2004 005
Application Review
The undersi acknowledges that before this request can be considered and/or approved, all
9 must be P aid to the Cit An incomplete
re information and fees? 'Including an deposits,
application will be returned to the applicant. The application approval process commences and
an application is considered complete when all re information and fees are submitted
appropriately to the Cit
Professional Fee Responsibility erstandin of the undersigned t hat all Cit incurred professional fees and expenses
It is the und
associated with the processin of this re will be promptl paid upon receipt. If pa
is not received from the applicant, the propert owner acknowled and a to be
responsible for the unpaid fee balance either b direct pa or a special assessment
a the propert
Applicants will be billed on a monthl basis for Plannin En Le and Communit
Development fee$ as the are accrued. It is understood that interest will be char on the
account at the maximum rate a[lowed b the Fair Credit Act if it becomes thirt (30) da past
due. Failure to pa administrative and processing fees in a timel manner ma result in denial
of the application. All fee$ must be paid at the time of application and shall be paid prior to the
issuance of a buildin permit.
The undeNigned applicant further acknowled and consents that all unpaid fees owin the
Cit of Oak Park Hei shall be treated as unpaid utilit fees and ma be certified for
collection as with delin utilit billin , and ma be assessed a the subject real
,
propert if unpaid b October 31' of each y ear.
Property Address
UAUA
Owner Signature
00
Applicant SiffnaturoF
Date; l01�0 y
Date: 7 _rj *17S . 6 q