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REQUIRED SUB^aTTALS <br />r.L.!l!."!L":!!!fi^'' »■■«d.., I, <br />__ Completed Application Fonn <br />---- Certified Property Owners List of owners within 150', labels and nlat man <br />must obtm this list, labels and map from Hennepin County olpaZen?^ of <br />Finance, A-603, Govt Center. 348-5910). ^ department of <br />---- Certificate of Survey (signed by a licensed surveyor) and include hardcover <br />_ To^graphic suivy (exisUng and proposed elevations) if «.y u, <br />grade arc proposed. In addition, provide one (1) copy 814” x 1 r* for ^ <br />- f• f“view/&* 1*,')'j" <br />---- List of the leg^ names (include marital status) of all persons with^an interest <br />the Prope^- This would mclude name(s) of applicant(s) if not current ownerfs) <br />_ As an addendum to this application, please atoch a s^ate lTof\^7oie; <br />persons you wish notified of this application. <br />---- Additional items as may be requested by City staff. <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />The Applicant and Property Owner must sign this appiication. Please remember that vmrr <br />Yirignct gppImHtin » wot tomphie If the above Information h.« l■.et.■J«a <br />APPLICANT'S SIGNATURE <br />me appliemt hereby agrees to provide all information required or requested by the Zoruna <br />Admtmstrator. agrees to pay additional fees (staff time not covered by original fee pa™«n <br />an^or consultanl expenses meurred in review of this application, and cer^if" ST“e <br />information supplied is true and comet to the best of hisdier knowledge. <br />Applicant ’s Signature ________________ Date / /S.02. <br />OWNER'S SIGNATU^ <br />The owner hereby acknowledges and agrees to this application and further authorizes reasonable <br />memb^Tfn ‘consultants, agents. Commission members. and^^^cU <br />members for purposes of mvcstigati^and verification of this request. <br />Owner's Signature <V •Date <br />Applicant must have all submittals into the City offices 25 davs hefcirsw ti,« ou • <br />mo^^ a" Commission Meetings are held on the third Monday of each <br />month. Applicants must be present at all scheduled review meetines of the Plannino <br />»f <br />Y: <br />JJ <br />- •>-/ <br />' i'*-. ? <br />A <br />a/ <br />•?jp <br />ii* <br />•.V <br />• J