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REQLTRE0 SUBMITTALS <br />1. <br />2. <br />3. <br />Completed Application Form. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <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. 348-3'>7n <br />Plat Map. ’ ** <br />. Cenificate of Surrey (signed by a licensed surveyor) - refer to handout for sur^ev <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 mantal satus) of all persons with an interest in the <br />property. This would include rame(s) of applicants) if not current owner(s) <br />Construction plan, if ipplicable (see suff 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 />YOU ARE REQUIRED TO SUPPLY 30 COPIES OF LARGE DOCL^IENTS OR COPY <br />SMALLER) FOR ALL DOCU^IEN tI <br />SUBMITTED. (Suff will require to scale drawings of all documents, plan;, etc to be <br />submitted.) <br />The Applicant and Propeny 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 SIGNATL'RE <br />The applicant hereby agrees to provide all information required or requested by the Zoning <br />Administrator, agrees to pay additional fees (staff time not covered by original fee pavment) <br />and/or unusual expenses incurred in review of tins application, andeenities that the information <br />supplied IS true and correct to the best of his/her knowledge. <br />Applicant’s signamre Date <br />OWNTR’S SIGNATLTtE <br />The ow ner hereby acknowledge^ and agrees to this application and further authorized reasonable <br />entry onto the property by f ' staff, consultants, agents, commission members, and Council <br />members tor purposes .^stigation anyk-r^fme^tion of this request. <br />Owner’s signature ^ L Date- fa f ----------udie / "*o< 0 ________