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0 Plat —Sketch Plan <br />0 Administrative Plat <br />'Conditional Use Permit <br />❑ Zoning Amendment <br />0 Dwelling Moving Permit <br />Non Traditional Animal License <br />Name: <br />Street Address: <br />City, State, ZIP: <br />Home Phone: <br />Ei Plat— Preliminary Plat <br />Q Site Plan Review <br />Interim Use Permit <br />❑ Home Occupation Permit <br />❑ Environmental Permit <br />❑ Beekeeping License <br />Land Use Application <br />Plat — Final Plat <br />I❑ Easement/ROW Vacation <br />Comprehensive Plan Amendment <br />Variance <br />El Registered Land Survey <br />0 Private Kennel License <br />Applicant Contact Information <br />Please note: All official communication will be routed through this contact. <br />2. be_LCa <br />Y+`'j - <br />Email: <br />Name of Business (if <br />applicable): <br />Business Address (if applicable) <br />Business City, State, ZIP <br />Business Phone: <br />Address <br />PIN <br />Legal Description <br />IZoning District <br />Contact the Planning Division at 763-433-9824 or olannina(5 citvoframsev.com to request a Zoning Verification <br />n eap of�s� Ill <br />aka '�3 1 - DISS" <br />L i- <br />Work Phone: <br />rc ba.otere°)rcu(, cam.,. Fax Number: <br />2lpa -334 —0 3S`'c <br />1 Business Fax: I — <br />Subject Property Information <br />(Location of Application) <br />l g G O X..1cc) 1-i, ed iv of ow) , i-4 J <br />Og-2,S-2_3- 00 I <br />2 <br />'� 1c sc3 1 ©�' /U{,tJIF( off'Scc3 I, p RGtzS; EX RDSkb) <br />