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j <br />if • <br />U///I . <br />7. <br />8- <br />9. <br />10. <br />required submittals <br />X • ,/Completed Application Form. <br />L Describe request in detail. <br />Certified Property Owners List of o™rs 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 leeal 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 sams) of all persons with an mterest m the <br />-----property. This would include name(s) of applicant(s) if not current owner(s). <br />Constniction 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 />SUBMITTED. (Staff will require to scale drawmgs 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 />The^appli^ tefel^^ag^^ provide all information required or requested by the Zonmg <br />^druSs^m agrees to pay additional fees (staff time not covered by original fee payment) <br />"S cx;ScsTurred in review of this application, and certif.es that the mformatton <br />supplied is true and corTecjr-'fo^e best of his/her knowledge. <br />Applicant’s signature Date ///jU/f^ <br />mJ^Seby ^edU^d agrees to this applicauon <br />entry onto the property by City staff, consultants, agents, comnussion members, and Co <br />members for purposes oLifi^tigation and verificauon of this request. <br />Owner’s signamre Date '/uM <br />Applicant must have all submitLilvntow City offices a^iliiytliefore the Planning Comm^oo^ scheduled <br />SoLission Meetings are held oUe^ <br />review meetings of the Planning Commission and Council. If an app advise the Building & Zoning Office <br />please make arrangements to have an authorized agent attend m your p <br />of this change prior to the meeting.