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dote reed <br />r <br />.YW - 7 W fee ec «yp� <br />:ITl' CI' ORONO r 36'e'maa�' <br />SUR:ICISION APPLIt:ATI FORM � �' <br />APPLICANT Name _ n� - _ Telephone <br />Mailing <br />Address-- <br />ROPERTY Name _ M 41L _ ----- Telephone —_— -- _ <br />^IERS Mailing <br />Address -- --- _-__-. <br />)Attach list of more than ono <br />I'R')rERTY LOCATION <br />Street Address y j44v <br />Legal Description J 1 > m <br />EXISTING LAND USE <br />Number of Tax Parcels <br />Development Size <br />Present Use (chock) T <br />Present Zoning Dist. _ hj.-I/ <br />Acres Ors• Land <br />Acres Wet Land <br />Acres Total, all parcels <br />Residential; no. of units <br />Other (specify) <br />PROPOSAL lot line rearrangement only (no new building sites) <br />_ subdivision for new building sites <br />number of building sites: existing units <br />.� new units <br />_ 3 total units <br />proposed gross density units por)� acres <br />minimum lot sire: � square leit•dry buildable land <br />proposed use: (check) —residential <br />other (specify) <br />MINIM';M MATERIAL NECESSARY FOR COMPLETE APPLICATION <br />(Must be submitted 30 days prior to Planning Commission meeting) <br />1. APplicatioo Completed 5. Applicatlon fee per current fee schedule: <br />PnlWeary Plat isfenatlun on sketch plan only SSu.uu <br />a certificate of survey <br />1. Certified Property Owner's list of 2 lot prelim. plat 1SU.07 =". N <br />A-'. with(. 110' - tro. Nennepin )e lot prelim. plat am eeD� <br />Co. Dept. of Plnance A-bo) Wvern- (:ketch plan included) 4 sl(i/lot <br />rat Center <br />•. stamped. I"Al sited envelopes (flu) additional improvement <br />pre -address" to each of -he names on review fees per fro <br />sc nodule s <br />the above list. <br />APPLICA11 S SIGNATURE al ),i•-4 1 r',luui• ;t <br />DATE OMNER'S Sl�uATURE _ <br />Applicant hereby agrees to provide all information required or requested by <br />the Zoning Administrator, City Engineer, City Attorney, Planning Ctrmission <br />and Council necessary to process ti.is al.plication and further agrees to pay <br />.li .. iitiar.sl foes established L) ur,:ir,er,c.. <br />vJ <br />