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r <br />4. <br />5. <br />6. <br />7. <br />hit list from <br />S4a-S271). <br />It for iurv«y <br />ey. <br />long Involve <br />RBQUXKKD SUBMTTTAI-S <br />]. Cofspleied Appllcatioa Form. <br />2! Deicrtbe request In detail. <br />31 ~ Certifled ProperQ^ Ownan Uit of ouxen ('f’ <br />Heooepia Couot^ Deputment of FlDADce, ^ <br />Pitt Mip. <br />Cenifleatf or survey (itgnad by i llceose <br />Infonnttion. <br />Atucb leg il daicrIpUoa to ipplictiloo if i <br />Topognphlc lurvey (exlfUsg end propo <br />cbtmes In elevation (grtdei). <br />Uft of Ibe legal namei (Include mariui tatus) of idl pertoos with an imartst In the <br />property. Thli would Include named) of appllcantci) ir not current owcer(«). <br />Conitruedon plan, If applicable (see fttff for requirements). <br />As an addendum to this application, plena attach a separate lUt of any other ptriuns <br />you wish notified of this application. <br />YOU AKE REQUIRSD TO SUPPLY 30 COPIES LAKOS DOCUMENTS OR QW <br />FOR REPRODUCTION (U” X 17 ” OR SMALLER) FOR ALL DOCUMENTS <br />SUBMITTED. (Staff will require to scale drawings of all dccumsntf. plans, etc. to be <br />submitted.) <br />The Applicant and Property Owner must sign this application. Pleaae remember that your <br />application li not complete if the above Information has not been Included. <br />Certification by Clerical Department that Land Use Appllciilon li complete, <br />Inldali of Clerical Staff; _______________m ' '—1 <br />9. <br />10. <br />^^applSml hoSS^lgm^ provide all InfonnaUon required or request^ by the Zoning <br />AdmlnJtotor, ageees to pay additional fees (staff time not covered by original fw payment) <br />and/or unusual expenses Incurred In review of this spyllcatlon, and certifies that the Information <br />supplied is true and eoim« to the tAit_of hla/lter l^p'^ledge <br />Applicam'i signature Date <br />OWNER’S SIGNATURE ^ ^ j w,The owner hereby acknowledges and agrees to this ippUcatlon and further aut^rixed reasonable <br />entry onto the prtmerty by City staff, consulianti. agents, commission mcmbsri, ind Council <br />members for puipoiei of lu^itieation sndUtcriflcsiion of this request, <br />Owner's signature Date <br />A»U«. «.t h.« .Jl nbmIM. to. & aw .»"» M <br />Ceanliiloa Mwlni, in h.M «. tb. AM Moa^y »f uuM™ JmS, idud^'^lu. <br />of Uui cliau|« pderio Um aieeiiaf* ' \ <br />-fl V <br />I <br />•} <br />f • <br />\