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MPR-22-1996 13:30 DOU»€Y ENGEBRETSON 612 334 3332 P.03/04 <br />•) <br />4 0 <br />4. <br />REQUIRED SUBMnTALS <br />1. ____ Completed AppUcaiion Form. <br />Describe request in detail. <br />Certified IWeny Ovwien List of o»men within 3t0'. Ubels and plat map (yon <br />must obtatn thla list, libels end map fiom Hennepin County Department of <br />Finance, A»603, Oovemmenl Center, 348-3271). <br />Ccftificaie of Survey (signed by a licensed surveyor) - refer to handout for survey <br />m <br />information. ... • ^ <br />Attach legal description to application if not included on rcqmrrt survey. <br />' Topographic survey (existing and proposed contours) if land alterations involve <br />changes in elevation (grades). . _ ^ . <br />List of the legal names (include marital status) of all persons an interest m <br />* property. This would include namc($) of apphcam(s) if not current owner(s). <br />Construction plan, if applicable (see staff for requirements). <br />■ As an i^endum to this application, please attach a separate list of any other <br />persons you wish notified of this application. <br />5 <br />6 <br />7. <br />8. <br />9. <br />” -------------------------------------------------- <br />SUBMITTED. (Staff unll require to scale drawings of all documents, plans, etc. to be <br />submitted.) <br />The AppUcant and Property Owner must sign this application. Please remember that your <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 />supplitd is true uvd correct to Uw tot of hisAer knowledge, nuommuo pp <br />OWNER’S SIGNATURE ^ ^ u .*1. • jHie owner hereby acknowledges and agrees to this applicauon and fiirthw nuthonaed <br />reasonable entry onto the property by City staff, eonsultairu. agents, coinmissron members. <br />and Council members for p^ses^investigation and verification of this request. <br />________Date ^Owner's signature .. / <br />A mast have aU •ubmittaJi ^iido the Cify offleta 25 dijn before the PUaniag Commission Meeting. <br />Appli^t ra Meetings are held on the ihW Monday of each month. Appllcents must be present u <br />Pluto, Cuniuirri.. uid Couuil. If m .pplicul. b uaabi. » ae.nd . <br />meeting, plow, make *<> “ ewthonzed agent nitend in your pLc. end advise the <br />Building A Zoning Office of this change prior to the meeong. <br />rAR-22-1996 13:33 612 334 3332 99/.P.03