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’1 <br />Mr* Koll: Please fill out in duplicate the top half of this form. <br />Return it so that your request can be considered at the Plannin <br />Commission,Oct.21,1965, 7:30 P.M. 3 f <br />VIliAGli OF OEONO No. <br />Crystal Bay, Minn. <br />RFQlIbST FOR SITE EXAMINATION <br />(Complete in Duplicate) <br />This form to be used in all applications for i)enuits for building, plumbing, sewage <br />disposal, rezoning, moving a structure, dividing or consolidating parcels of land. <br />Type of Application qP Property <br />Owner of Property: Name Eileen Koll_ _ _ _ <br />Date October 16, 1963 <br />Phone No. 473- 7207 I <br />Address n», g 7Sn lilayyata, WlnnHaota <br />Applicant (other than owner) Name Bernard E. Koll Phone No. 473- 7207 <br />Address Rt. 5 Box 250 Wayzata, Hinnesota <br />Relationship to Owner Hnohanri <br />Location (How do we find it?): 4- mile north of village hall on county road 146 <br />Legal Description: Part of Gout. Lot 6 In Sec. 10. T. 117 Mo.. R, 23 Ueat Pd.k^Jlit eo <br />Date Acquired Area (sq. ft.) mion______ Single Ownership? ypa <br />Separate Ownership? <br />Date of last Division of this Property ftlone <br />Do you own auiy Adjoining Proper!y?__None <br />Action Requested To divide property shoyn on sketch <br />Attach sketch, plat p3an or survey and any additional data. <br />C- C // <br />Signatiu*e of Applicant <br />RECORD OF ACTION TAKEN <br />Application Received by <br />Referred to: <br />Date / o- PI 3 No.^ <br />Date <br />3(r <br />Inspection Conducted bj; <br />Recommendation <br />Date <br />Planning Ctxnmission - Date Considered / o~ 7 /» C-Recommendation: <br />" » f -- - - - - - - - - - - ■ <br />Planning Commission Subcommittee - Date Inspected, <br />Recommendation <br />Chairman <br />Planning Commission - Date Recommendation: <br />Council - Date / 6 Action Taken ^ ~ 2-3 <br />Permit Issued - Date