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r <br />required submittals <br />1 <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />Completed Application Fonn. <br />~T Describe request in detail. <br />------Certified Property Owners List of owners within 350’ (you can obtain thi.» list from <br />Hennepin County Depamnent of Finance, A-603, GovTmment Center, 348-3271). <br />Plat Map. <br />--— Cenificate of Survey (signed by a licensed sur\eyor) - reter to handout for sur%cy <br />information. ., • , j . • j <br />Attach Iceal dcscripncfl to application if not included on required survey. <br />Topographic survey (existing and proposed contours) if land alterations involve <br />” changes m elevation (grades). <br />V List of the legal names (include marital satus) of all persons with an mtcrest 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).ConstnicTion pi-m, u v— ------- -----------. <br />------ As an addendum to this application, please anach a separate list of any other persons <br />you wish notified of this application. <br />SUB.MITTED. (Staff will require to scale drawmgs of all documents, plans, etc. to e <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 inc.udtd. <br />Certification by Clerical Department that Land Use Application is complete. <br />Initials of Clerical Staff: ---------------------------------- <br />APPLICANT’S SIGNATLTlb or requested by the Zoning <br />The applicant hereby agrees tim^pot covered by original fee payment) <br />Administrator agrees to pay and certifies that the informationand/or unusual expensesjneurred ih^Mevv pi this app^^ <br />supplied is true apd^orrect to th^^st-^l^^her kn^^dg^^ orj ^ ^'I <br />,. , / tAL ' Date r AA.Applicant s signature <br />OW'NER’skiGNATLRE Xh e n/.lintion and further authorized reasonable <br />membecr for utnp^es of and verificption of ^J^eq <br />Owner ’s sigmture <br />I / ll1 /I <br />Applicant muA have all submiry ls ini <br />Planning <br />“yoJ?p.- -a .avuc .h. 4 zooi.. OfBc <br />of this change prior to the meeting