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Land Use Application <br />❑ Plat — Sketch Plan <br />❑ Plat —Preliminary Plat <br />❑ Plat —Final Plat <br />❑ Administrative Plat <br />❑ Site Plan Review <br />❑ Easement/ROW Vacation <br />Conditional Use Permit <br />❑ Interim Use Permit <br />❑ Comprehensive Plan Amendment <br />❑ Zoning Amendment <br />Home Occupation Permit <br />❑ Variance <br />❑ Dwel4ing Moving Permit <br />❑ Environmental Permit <br />❑ Registered Land Survey <br />❑ Non -Traditional Animal License <br />❑ Beekeeping License <br />❑ Private Kennel License <br />Applicant Contact Information <br />Please note: All official communication will be routed through this contact. <br />Name: <br />Gob 30\f1nSmn <br />Street Address: <br />S-351 1� 0 <br />City, State, ZIP: <br />Home Phone: <br />Work Phone: <br />I Z—WS'0 6 /-7 <br />Email: <br />�m 0\'1n5�P Cew. <br />Fax Number: <br />Name of Business (if <br />applicable): <br />Business Address (if appiiicable) <br />Business City, State, ZIP <br />Business Phone: <br />Business Fax: <br />Subject Property Information <br />(Location of Application) <br />Address <br />351 ` OAV) hVt ►V\AJ <br />PIN <br />I'i(��j2-�j —�� 0do3 <br />Legal Description <br />Zoning District <br />Contact the Planning Division at 763-433-9824 or plarininy clt o rnmse , cord to request a Zoning Verification <br />Scanned with CamScanner <br />