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REQUIRED SUBMITTALS <br />____Completed Application Form. <br />____Describe request in detail. <br />------Certified Proj^rty Owners List of owners within 350', labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Department of Finance <br />-A-603, Government Center, 348-3271). ’ <br />------Certificate of Survey (signed by a licensed surveyor) - refer to handout for survev <br />------Attach legal description to application if not included on required survey <br />------Topographic survey (existing and proposed contours) if land alterations involve <br />changes in elevation (grades). <br />------List of the legal names (include marital status) of all persons with an interest in the <br />property. This wo^d include name(s) of applicant(s) if not current 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 notifi^ of this application. <br />-SI! REQUIRED TO SUPPLY 30 COPIES OF LARGE DOCUMENTS OR COPY <br />^ SMALLER) FOR ALL DOCUMENTS <br />SraimrrED. (Staff will require to scale drawings of all documents, plans, etc. to be <br />submitted.) <br />The Applicmt and Property Owner must sign this application. Please remember that your <br />applicauon is not complete if the above information has not been included. <br />Certification by Clerical Department that L'^nd Use Application is complete <br />dnitials of Clerical Staff:_____________________ Date <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />APPLICANT'S SIGNATURE <br />The applicant hereby agrees to provide all information required or requested by the Zoning <br />Admimstrator, agrees to pay additional fees (staff time not covered by original fee payment) <br />and/or unusual e.xpenses incurred in review of this application, and certifies that the information <br />supplied IS true and correct to the best of his/her knowledge. <br />Applicant’s signature Date oc^ S'L. <br />OWNER’S SIGNATURE <br />The owner hereby acknowledges and agrees to this application and further authorized reasonable <br />entry onto the property by City staff, consultants, agents, commission members, and Council <br />members for purposes of investigation and verification of this request. <br />Owner's signature Date <br />Building A Zoning Office Of ihU Change prior 10 the meeiing.I • <br />*