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06-27-1997 10:44hM FROM 9D9M SMITH CO 16124719650 P.0; <br />#.2g6.7REQUIRED SUBMlTTALIi <br />1. ____Compltlid App}ictt!on Fomt <br />3 CeftMcd Sp«tr Ovwim List of ownen willua'535^, lab^ind plot m«p (yw <br />mu$t obtdn this Ust. bbels snd m«p fiom Hennepin County Dcpettmeai of <br />Fimoott A«603* Oovemmeni Centtr* 34t«S271). <br />4. CotUkMl of Survey (ngned Vy a Coemed surveyor) - refer to bendoot for survey <br />7. <br />docr^ption to a|q|}Ucadott if not wdudod oo rei|uifto siffvey.^ <br />Topoynihio survey (existing and proposed contours) if lend elteietions involve <br />hi elevatum (giedes). <br />Lilt of the legs] ncmes Onclude inariul status) of ail pawns with an nteroA in <br />foi pcopcity. This wouW ir^*4* Mnie(s) of ^tplieam(s) if not current ownei(s). <br />Coostnictioo plan, if ^rplieable (see staff for reQUlmnents). <br />§B fjdttvh**" to»diU application, please att^ a s^cioe list of any other <br />poeons you wish notified of this app^atloo. <br />YOU ARE REQUIRED TO SUPPLY 39 COPIES Of LARGE OOCUMEfiTS OR COPY <br />FOR REPRODUCTION (ir* X 17” OR SMALLER) FOR ALL DOCUBtENTO <br />SUBhilTTCD. (Staff will require to scale drawings of all documents, plans, etc. to be <br />lubfliitMd.) <br />The /^Ikent and Property Owner must sign this appllcaiioo. Mease remember that your <br />gp^kttlon is not eon^dote if the above iaforawiion has not been included. <br />CettifieRion by Clerical Department that Land Use Application is complete. <br />Initials of Clerical SltfC______ — D***• •• • • <br />APPUCANrS SIGNATURE __,u. , i <br />The oplicant hereby agrees to provide all infonnation required or requested by the Zoning <br />Adrolnistrotor. agrees to additional fees (staff time not covered by original^ foe payine^ <br />andfor unusual expooKi incurred in review of this appUcetion, and cotiflos that the <br />infoRMtion suppHad Is true and oorwet to the best of hlsfoer kno <br />AppUcoifo aigaRuro /O Dais..hhalu <br />0WNER*S BlONAtVU. , . ^ , <br />The owner hereby aduiowledges and agrees to this application and form authonxeu <br />itasonaUe ontry onto the property by Clhr staff, coatultants, agents, coaanission memoers, <br />« ^__________t___-------------------of AliS nHUCit*and Council niembeij for purposes of iavatigation and verification of diis request. <br />A*------------- <br />OwnePs signature <br />Apeltarot men have ■» •ubotinsU Into the City ofTiea 25 dsyt befot ihe Ptowly Cowmhilon <br />floiaisa Commlwion Mctiiiip «» h«M on ib* third Mendqr ©f owh mosth. ■ <br />4^ Zeasig Oftio* ©r dii> chwifc prior (a the nectiag. <br />TOTAL P.02