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^ - (jy{)' fZJ <br />required submittals <br />_ ^ ^ A • <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />Completed Application Form. <br />Describe request in detail. <br />Certified Properly Owners l.ist of owners within 330', labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Department of <br />Finance, A-603, Government Center, 34^-3221). <br />Certificate of Sur\ey (signed by a licensed surveyor) - refer to handout for sur\cy <br />information. . <br />Attach legal description to application if not included on required survey. <br />Topographic survey (existing and proposed contours) if land alterations invohe <br />changes in elevation (grades). <br />List of the legal names (include marital status) of all persons with an interest m <br />the properly. This would include namc(s) of applicant(s) if not current o\\7icr(s). <br />Constaiction 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 />von ARE REQUIRED TO SUITLY 30 COIMES OF LARGE DOCUMENIS OR COI ^ <br />FOr CpScTION .X 17" OR SMALLER, FOR ALL I,OCUME^^ <br />SUBMITTED. (Staff will require to scale drawings of all documents, plans, etc. to <br />submitted.) <br />The Applicant and Property Owner must sign this application. Please remember that yon; J <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 />Initials of Clerical Staff:___________________________ -------------------------------------- <br />wi <br />I <br />ThTtpplfcant Lfeb^y^agrees \o provide all infortnalion required or requested <br />Admiidstrator agrees to pay additional fees (staff time not coveted by original fee pay"’™') <br />“ “expenses incurred in review of this/PpHcation and certifies that the <br />information supplied is |rue^^ correct t^ best of^s/licr knowledge. <br />Applicant ’s signature Date <br />?” “Zowled^es and ^es to this application and firrther autboriaed <br />Jeasonab^ entry Lto the property by City staffi eonsultants. agents, commission members, <br />and Council members for purposes o^Investigation and verification o is req^ <br />DateOwner’s signature I^ <br />all scheduled review meelinss of the Plaaniag Commission and ^ ,„c <br />scheduled meetina, please make airangemenls lo have an aulhonzed n„enl y P <br />Building & Zoning Office of this change prior to the meslmg.