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10-'24^9T IX-.ZZ RE rwx EXCELSIOR ei2S5l4<?43: P^r^«»or.,c Ri-tx srsren pmdne no. :mqvt CC*’ELCr^^’E’i-NO.072 002Oct. 24 1997 12:10PN P2f y pes i>:t U *07 10:13R£OXJI1ULD submittals <br />1 <br />2 <br />.Sy'.•r i <br />// <br />/* ■:] <br />i-*-; ;.:;j k <br />5 <br />6 <br />< <br />.jL <br />Completed Application Form. <br />Describe request in deuil. — <br />Certified Property Owners List of owriers within ?5Q-. labels and plat ma^S^u <br />Survey (signed by a licensed surveyor) • refer to handout for survey <br />Attach legal description to application if not included on required survey <br />Topographic survey (e.xisting and proposed contours) if land alterations involve <br />changes sn elevation (grades). <br />List of the !eg^ names (include -.uiial status) of all persons with an interest in <br />we property. This would include nAr,ic(s) of applicant(s) if not current owner(s). <br />Construction plan, if applicable (sw 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 app'^’cai on. <br />SUPPLY 30 COPIES OF LARC.E DOCV7VIENTS OR COPY <br />SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require to scale drawings of all documents, plans, etc. to be su Dfn ittc<i. j <br />The Applicant and Property Owner must sign this application. Please remember Wat vour <br />application is not compJeie 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 />8. <br />9. <br />APPLlCAiVT'S SIGNATURE <br />The i^pUcant hereby agrees to provide all information required or requested by the Zoning <br />Ad^iustrmtor. agrees to pay additional fees (staff time not covered by original fee payment) <br />arm/or unusual oepenses incurred in rd\*iaw of this application, and certifies that the <br />information supplied is true to the best of his/her knowledge. <br />Applicant's signature _ ____________________Date ________ <br />’•^4.,0'WNER'S SlONAff^RE <br />The oiwer hereby acknowledges and agrees to this application and ftirthcr authoxizwi <br />reosc^able entry onto th^ proporty by City staff, consulfants, agents, commission mombars, <br />and Coiirtcil members forp^poses of investigation and verification of this request. <br />Owner’s signature <br />ea <br />4