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XI mJm n*A <br />required submittals <br />Completed Application Form. <br />Describe request in detail. <br />------Certified Property Owners List of owners within 350’ (you can obtain this list from <br />------ Hennepin County Department of Finance, A-603, Government Center, 348-3271). <br />Plat Map. <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 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 satus) of all persons with an interest m 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 />vou wish notified of this application. <br />YOU ARE REOLTRED TO SUPPLY 30 COPIES OF LARGE DOCUMENTS OR COPY <br />FOR REPRODUCTION (11 ” X 17 ” OR SMALLER) 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. Please remember that your <br />application is not complete if the above information has not been mcluded. <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff:__________________________------------------------------------------ <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />S. <br />9. <br />10. <br />Tte appli^ pravide all information required or <br />AdmMstraior, agrees to pay additional fees (staff time not covered by <br />and/or unusual expenses incurred in review of this application, and cerufies that the mf <br />supplied is true and correct io the best of his/^ knowl^ge. <br />X Aprnn.nr'..i.namre ^ _Date f h ^ <br />' Bruce Bren, President <br />The owner hereby acknowledges and agrees to this application and further <br />entry onto the property by City staff, consultants, agents, commission members, and Counc <br />members for purposes of investigation and verification of this request. <br />Owner’s signature _Date <br />Applicant must have all submittals into the City offices 25 days before the Planning Cotr^^ion Meeti^. <br />CoLissicn Meetings are held on the third Monday of each month Appl-cants ^ be <br />review meetings of the Planning Commission and Council. If an ^plicant is^a n„ndine & Zoning Office <br />please make arrangements to have an authorized agent attend in your place and advis S <br />of this change prior to the meeting.