HomeMy WebLinkAboutNon-conforming expansion Community Development Department
7071 University Avenue NE
Fridley MN 55432
763-572-3592
Fridley Fax: 763-571-1287
w-ww.fridleymn.go`-
NON-CONFORMING EXPANSION PERMIT
Property Information
Address: I(C00 - -�rf' - � � t,� '
Anoka County Property Identification Number(PIN#):
Legal Description: Lr1r. L �
Current Zoning: Square footage of Parcel:
Description of Non-Conformity: (one sentence summary, attached full description)
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Non-Conforming Expansion is Requested to: _
Fee/Property Owner Information (as it appears on property title)
**Fee owner must sign this form prior to processing
Name (please print):
Mailing address: �' , �, -< 44
City: ,;) 1 , State: !A N Zip code: Vivj'a3
Daytime Phone: Wi, Acr)L Fax Number:
Cell Phone:j'b�Z1a5^LjCk,) E-mail address: "'koaLY-NaV,
Signature/Date: 2A L,0
Petitioner Informati n
Company Name (please print):
Contact Person's Name (please print): ®16,yEt-
Mailing address:
City: State: V1Ai' Zip code:
Daytime Phone: U t °-`A- j �o*S Fax Number:
Cell Phone: E-mail address: `Y\�)h VY1�_A J' a
Signature/Date:
FOR OFFICE USE ONLY
Fees
$200
Application Number: Receipt#: Received By:
Application Date:
60 Day Date: