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-»-»• • I I i P. rj2 IV <br />I <br />1 <br />REQU1RF.I) submittals <br />inforinatiori TQiij.t be submitted bv the application deadline date in <br />order for V9»r appjjcn.ti«>n to he -------^ <br />Completed Application Form <br />---- Certified Property Owners List of owners within 150', labels and plat map (you <br />mubt o tain this list, labels and map fiom Hennepin County Department of <br />Finance. A-603, Govt Center. 348-5910). <br />— Certificate of Survey (signed by a licensed suncyor) and include hardcover <br />ca cu a tons as required. In addition, provide one (1) copy 8‘/i" x 11" for <br />reproduction. <br />— Topographic survey (existing and proposed elevations) if any changes in existing <br />gra e are proposed. In addition, provide one (1) copy 8‘A" x 11" for reproduction <br />---- Sketetes or plans of floor & elevation views (pro\ide one (1) copy S'/j" x II'*) <br />r! S' apPlicant(s) if not current owner(s). <br />,— n to tins application, please attach a separate list of any other <br />persons you wish notified of this application. <br />,— Additional items as may be requested by City staff. <br />The Applicant and Property Owner mtm sign mis application. Please remember that vsur <br />yariaiiw appi,rattan H BOI eotnt.let. if th, .hev. i,r„,-,..j,,n been inel..ded <br />APPLICANT'S SIGNATURE <br />The appliewt hereby agrees to provide all information required or requested by the Zoning <br />AdoumstratoE agrees to pay additional fees (staff time not covered bv original fee paymem) <br />an^or consultant expenses meureed in review of this application,' and certifies th^ the <br />information supplied is true and correct to the best of hisfiier knowledge. <br />Applicant’s Signature____________ <br />5, <br />6. <br />7. <br />8. <br />Date <br />OWNER’S SIGNATURE <br />actoowlrfges and agrees to this appUcation and further auth’orixes reasonable <br />^ y ity staff, consults, agents, Commission members, and Council <br />members for purposes<^nvestig^n an^erification of this request. <br />Owner’s Signature Date l-‘ 1 6 -t <br />Commission and Council. If an applicant is unable to anend a scheduled meeting please <br />^fonTp'^oT I ^ the flmlding& Zonmg Office of this change prior to the meeting. <br />COO/COOP)nos.cjv <* RM^rvM Himv Klftft l/R 710 VVJ CP;*T Tnrt7/OT/TO