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•'T <br />*u % ■%1 <br />t ' <br />2. <br />3. <br />4. <br />REQUIRED SUBMITTALS <br />1. j|___ Completed Application Form. <br />____ Describe request in detail. <br />____ Certified Property Owners List of owners within 350', labels and plat map (you <br />must obtain this list, labels and map from Hennepin County Deportment of <br />Finance, A-603, Government Center, 348-3271). <br />____Certificate of Survey (signed by a licensed surveyor) - refer to handout for survey <br />information. <br />Attach legal description to cpolicotion if not included on required 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 with an interest in <br />the property. This would include name(s) of applicant(s) if not current owncr(s). <br />____ Construction plan, if applicable (see staff for requirements). <br />____As on addendum 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 />YOU ARE REQUIRED TO SUPPLY 30 COPIES OF LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (ir* X 17” OR SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (SialT will require to scale drawings of ail documents, plans, etc. to be <br />submitted.) <br />I'he Applicant and Property Owner must sign this application. Please remember tljat 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; ________Date _____ <br />APPLICANT’S signature <br />The applicant hereby agrees to provide all information requited or requested by the Zoning <br />Administrator, agrees to pay additional fees (staff time not covered by original fee payment) <br />and/or unusual expenses incitrred in review of this application, and certifies that the <br />information supplied is true arvd correct to the best of his/her knowledge. <br />Applicant's signature <br />0 <br />0 . Date lO !_____ <br />OWNER'S SIGNATURE <br />The owner hereby acknowledges and agrees to this application and fiirther authorized <br />reasonable entry onto the property by City staff, consultants, agents, commission members, <br />and Council tnembers for purposes of Investigation and verification of this quest. <br />Owner's signature Date <br />Z7 <br />iis I <br />Applicant must have nil submittals Into the City ofllces 25 day* before the Planning Commission Meeting. <br />Planning Commission Meetings are held on (he third Monday of each month. Applicants must be present at <br />all scheduled review meetings of the Planning Commission and Council. If an applicant iS unable to auend a <br />scheduled meeting, please make arrangements to have an authorired agent attend in your place and advise the <br />Building Sl Zoning Office of thb change p.*lor to the meeting. <br />60*d 0£0'ON 0£:l7T 96.S2 130 2TU-£9^-02£:ai NQIiOndiSNOD T3 <br />I