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1 <br />• • <br />4*i# • <br />3. <br />4. <br />REQUIRED SUBMITTALS <br />All of Ihf following infnm.a.ion Iw ...hmittwl bv »h«! appli<atipn jline djt«; inorda <br />fnr your anniiriilion to be considered coniplctgj. <br />Completed Application Form <br />Cettified Property Owners List of owners wtthin 150’ (you must obtam this list from <br />^ Hennepin Coun^ Department of Finance, A-603, Govt Center. 348-3271). <br />y Plat Map (obuined with property owners list). . ■ , j ,. j <br />■y Certificate of Survey (signed by a licensed surveyor and iiK ude haricover <br />calculations as required. In addition, provide one (1) copy 8W all for <br />X Top^mZc 'survev (existing and proposed elevations) if any changes in existing grade <br />are proposed. In Addition, provide one (1) copy 8W" x 11" for r=P™ductiom <br />y Sketches or plans of floor & elevation views (provide one (1) copy S/i x 11 ). <br />List of the legal names (include marital status) of all persons with an interest in the <br />property This would include name(s) of applicani(s) if not current owner(s). <br />As an addendum to this application, please attach a separate list of any other persons <br />you wish notified of this application. <br />y Additional items as may be requested by City staff. <br />The Applicant and Property Owner must sign this application. Please remembw that J2l!£ <br />annlirnrlnn is not complete if the above information hds not hgen (ncMed. <br />applicant 's signature * « u *7 • <br />The applicant -.ereby agrees to provide all information required or requested by *' 2°^ <br />Administrator, agrees to pay additional fees (staff time not coveted by 5* <br />and/or consultant expenses incurred in review of this application, and certifies that the <br />information supplied is true and correct to the best of his/her knowledge. <br />5. <br />6. <br />7. <br />8. <br />9. <br />Applicant’s Signature Date <br />The owner hereby acknowledges and agrees to this application and further authorizes reasonab ^ <br />entry onto the property by City staff, consultants, agents, Commission members, and Councu <br />members for purposes of investigation and verification of this request. <br />Owner’s Signature 'A Date <br />this change prior to the meeting.