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^QUIRED SUBMITTALS <br />____Completed Application Form. <br />____Describe request in detail. <br />-------Certfied Pro^ 0™ers List of ovmers within 350’, labels and plat map (you <br />mtut ob^ this list, bbels and map from Hennepin County Department of Ftomce <br />A-603, Government Center, 348-3271). ruiuiitc, <br />------Attach legal description to application if not included on required survey <br />— clTglTt'eS -olve <br />------ status) of all persons with an interest in the <br />property This would include name(s) of applicant(s) if not current oivner(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 this application. <br />FOR "^P^SSJ^rtT'v'’.,'.‘1 documents OR COPY <br />SUBMrmi?”VSff^i!t/'' * ” S^^'ALLER) for all documents <br />suSdl ‘ pl“5. «C. to be <br />The Applicant and Property Owner must sign this application. Please remember that vour <br />application is not complete if the above information has not been included. <br />Certification by Clerical Department that Land Use Application is complete. <br />initiciiS of Clcnccil _________________________Date <br />1. <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 infonnation required or requested by the Zonine <br />Administrator agrees to pay additional fees (statf time not covered bv^original fee paymenO <br />and/or unusual e.xpenses incurred in review of this application, and certifies that the information <br />supplied IS true and correct tolthe bes^f hi^r knowledge. ormation <br />Applicant's signature ^**^^0*-*^ LAy ^_____ <br />OWNER'S SIGNATUI^ <br />to ‘Ws application and further authorized reasonable <br />entry onto the proi^<by City staff, wnsultants. agents, commission members, and Council <br />members for verification of this request. <br />Date <br />equest. i . <br />DateOuTier's signature <br />Applicant must have all submittals into the Citv offices '>3 davs befon. th.. di ,„ ■ /- <br />Planning Commission Meetings are held on the third Monday of each month ADDlic^?* <br />scheduled review meetings of the Planning Commission and Counrr iV ^ <br />scheduled meeting, please make arrangements to have an authorized agent an'lnd’’^» <br />Building & Zoning Office of this change prior Tthe meeting * P*"'* ** <br />..' i <br />u U <br />^ 6 <br />. / • • •. <br />ILi