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I <br />.V <br />- HI-^3 3?c o ^ <br />2. <br />3. <br />4. <br />REQUIRED SUBMITTALS <br />1. v/^ Completed Application Form. <br />^ ust of O*™. Ubc^ and Mp (you <br />must obtain this list, labels and map from Hennepin County Department of Finance, <br />A-603, Government Center, 348-3271). ^ r <br />Certificate of Survey (signed by a licensed surveyor) - refer to handout for survey <br />information. . <br />Attach legal description to application if not included on rcqui^ survey. <br />Topographic survey (existing and proposed contours) if land alterauons mvolve <br />fegal namefonclude marital satus) of aU persons with an mterest m the <br />property. This would include name(s) of applicant(s) if not current owner(s). <br />Construction plan, if applicable (sec staff for requirements). <br />As an addendL to this application, please attach a separate list of any other persons <br />you wish notified of this application. . riflj <br />/o. \ ci W <br />5. <br />6. <br />7. <br />S. <br />9. <br />FOR ‘ir TOR ALL DOCUMENT <br />SUBMITTED. (Staff will require to scale drawings of all documents, plans, etc. to be <br />submitted.) <br />Certification by Clerical Department that Lind Use Application is complete. <br />Initials of Clerical Staff __________________________ ---------------- <br />Th **^*^i>^ Lre^bv^a^rcw^ provide all information required or requested by the Zoning <br />Admidstrator agrees to pay additional fees (staff time not covered by original fee payment) <br />an“ S expenses incurred in review of this application, and certifies that the information <br />supplied is true and correct to the best of his/her kn^edge. <br />Applicant’s signanire Date 3 /fj$ <br />OWNER’S SKNA-^E application and further authorized reasonable <br />the property by City staff,"consultan^.^ents commission members, and Council <br />members for purpLs of investiga^and venfic^ of this request. <br />Owner’J <br />Date_If //i/f.s <br />Commission Meeimgs are teW coimcU. If an applicant is unable to anend a scbeduled m«tmg. <br />of this change prior to the meeting. <br />1 <br />j