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’^00%vO <br />'■nilmas <br />* /nr- /£?.-/•n <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 />4. Plat Map. <br />5 ____ Certificate of Survey (signed by a licensed surveyor) - refer to handout for survey <br />infonnation. <br />g Attach legal description to application if not included on required survey. <br />7’ Topographic survey (existing and proposed contours) if land alterations involve <br />changes in elevation (grades). <br />8 List of the legal names (include marital satus) of all persons with an interest in the <br />property. TlSs would include name(s) of applicant(s) if not current owner(s). <br />9 Construction plan, if applicable (see statf for requirements). <br />jQ As an addendum to this application, please attach a separate list of any other persons <br />you wish notified of this application. <br />YOU ARE REQUIRED 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 included. <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff:___________________________— --------------------------------------- <br />APPLICANT’S SIGNATURE <br />The applicant hcrebv agrees to provide all information required or requested by the Zomng <br />Administrator, agrees to pay additional fees (staff time not covered by original fee payment) <br />and/or unusual expenses incuired in review of this application, and certifies that the inlormation <br />supplied is true and correct to the best of his/her knowledge. <br />Applicant ’s signamre Date 2 <br />OWhfiER’S SIGNATURE <br />The owner hereby acknowledges and agrees to this application and further authorized reasonable <br />entjy onto the property by City staff, consultants, agents, commission members, and Council <br />mernbers for purposes' of investigation and verification of this request. <br />Owner’s signature ^_ Date 2^-22- <br />Applicam must have aU submittals into the City offices 25 days before the Planning Commission Meeting. Ptag <br />CoLiission Meetings are held on the third Monday of each month. Applicants must be present at tdl scheduled <br />review meetings of the Planning Commission and CouncU. If an applicant is unable to attend a scheduled oiwtmg. <br />please make arrangements to have an authorized agent attend in your place and advise the Buildmg & Zoning Office <br />of this change prior to the meeting.