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REQUI^D SUBMITTALS <br />1. V Completed Application Form. <br />2. Describe request in detail. <br />3. Certified Property Owners List of owners within 350’, labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Department of Finance, <br />A-603, Government Center, 348-3271). <br />4. ) Cenificate of Survey (signed by a licensed surveyor) - refer to handout for survey <br />information. — <br />5. <br />6. <br />information. ' ^ > <br />Attach legal descripti on to application if not included on require^.’ survey.-5^ *y't <br />7. <br />8. <br />9. <br />Tcoograpliic survey*(existing and proposed contours) if land alterations involve <br />changes in elevation (grades). <br />List of the legal names (include marital satus) of all persons with an interest in the <br />property. This would include name(s) of applicant(s) if not current owner(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 persons <br />you wish notified of this application. <br />YOU ARE REOLTRED TO SUTPLY 30 COPIES OF LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (11" X 17" OR S.MALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require to scale drawings of all documents, plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. se remember that your <br />application is not complete if the above information has not been I .ded. <br />Certification bv Clerical Department that Land U. *. -.rplication is complete. <br />Initials of Clerical Staff:____________________ _______---------------------- <br />APPLICANT’S SIGNATURE . . . ^ <br />The aupli'-ant herebv agrees to provide all information required or requested by the Zomng <br />Administrator agrees to pav additional fees (staff time not covered by origmal tee payment) <br />md/or unusual e.xpenses incurred in review of this application, and certifies that the information <br />supplied is tiue and corrects the best of his/her knowledge. <br />Applicant’s signature Date <br />OWNER’S SIGN.ATL’RE . ui <br />The owner herebv acknowledges and agrees to this application and further authorized reasonable <br />entrv onto the properrv bv City staff, consultants, agenLs commission members, and Council <br />members for purposes of investigation and verification of this request. <br />Owner’s signature _Date <br />of ibis change poor to the meeung. <br />L.