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REQUIRED SUEMITTALS <br />1 • ____Completed Application Form. <br />2. ____Descrbe request in detail. <br />____Certified Property Owners List of owners within 350' of the subject property, <br />labels and plat map. List, labels and map may be obtained from Hennepin <br />County Department of Finance, Goverament Center, A-603 300 South 6* <br />Street, Minneapofis, telephone 612-348-5910). <br />----Certificate of Survey (signed by a licensed suveycr) - refer to har.dcut for <br />survey information. <br />__Attach legal description to application if net incLded on required survey. <br />-----Topographic survey (existing and proposed contours) if land alterations <br />Involve changes in elevaton (grades). <br />-----List of the legal names (include marital status) of al persons with an interest in <br />the property. This would include name(s) of appl:cant(s) if not current <br />owner(s). <br />___Construction plan, if applicable (see staff for requirements). <br />-----As an addendum to this application, please attach a separate list of any other <br />persons you wish notified of th'is application. <br />YOU ARE REQUIRED TO SUPPLY 3 COPIES OF LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (11" X 17" OR SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require scaled drawings of all documents, plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. Please remember that <br />your application is not complete if the above information has not been included. <br />Certification by Clerical Department that Land Use Application is complete <br />Initials of Clerical Staff:__________________________Date ____ <br />4. <br />5. <br />6. <br />8. <br />9. <br />APPLICANTS SIGNATURE <br />The applicant hereby agrees to provide all information required or requested by the <br />Zoning Administrator, agrees to pay additional fees (staff time not covered by original fee <br />payment) and/or unusual expenses Incurred In review of this application, and certfies <br />that the information supplied is true and correct to the best of his/her knowledge. <br />Applicant's signature ^ ^ of\ <br />OWNER’S SIGNATURE <br />The owner hereby acknowledges and agrees to this appHcation and further authorized <br />reasonable entry onto the property by City staff, consultants, agents, commission <br />members, and Council members forj^p^s of invest'gation and ve.'ificaticn of this <br />Owner ’s signaturegOiVliintuiC - - y m- - - »___________ DatG ^ <br />at an scheduled review meetings of the Plannlr^g Commission and Council. Ifan appiicant is unable to <br />IS;"..,!. *7«>9®mento to have en authodzed agent aSend In yourand advto^^Bujding,» Zoning Office of this chaai^r io the meetino <br />Tf 4