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(attach additional sheets if necessary) <br />, IMD SUBMITTALS <br />All of the follouring infonsatioo ■ust be subadtted by tho applicatioa <br />deadliasi date la order for TOog application to be copsldered coipletei <br />1._ _Completed Explication Torm <br />2^^_Certified Property Cwners List of owners within 150' (you must obtain <br />this list free Hennepin County Department of Pinance A-603 Govt Center <br />34S-3271). <br />3. _Plat Map (obtained with property owners list). <br />4. _Certificate of survey (signed by a licensed surveyor) to Include <br />hardcover calculations as required (provide one (1) copy 8>s*xll* for <br />reproducti<»). <br />5. _ _Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy 8H*xll*). <br />€._ _S)cetches or plans of floor i elevation views (provide 1 copy 8H"xll“). <br />7. As an addendxis to this appllcatimi. please attach a separate list of <br />any other persons you wish notified of this application. <br />8, Additional iteais as eay be requested by City staff. <br />The Applicant and Property Owner euat sign this application. Please <br />reaenber that your variance application is not coaplete if the above <br />inforaatioo has not been incloded. <br />AFPLICABT'S SiaUiTUM <br />The applicant hereby agrees to provide all information required or <br />requested by the Zmiing Administratcr. agrees to pay additional fees (staff <br />time not covered by original fee payment) and/or consultant expenses <br />incurred in review of this applicatijyusnd certifies that the information <br />supplied is true and correct of his/her )cnowledge. <br />Applicant's Signature Cate <br />OWHEaS SIGHATURB <br />The owner hereby acleovledges and agrees to this application and further <br />authorizes reasonable entry onto the property by City staff, consultants, <br />agents. Coasaission msinhrrij and Council members for purposes of inveatiga** <br />tion and verification of this request. <br />Owner's Signature _ _ _ _ _ _ _Data J^j <br />Applicant must have all submittals into tht City offices 25 days before the <br />Planning Connission Meeting. Planning Conunission Meetings are held on the <br />third Monday of each month. Applicants must be present at all scheduled <br />review meetings of the Planning ConsLission and Council. If an applicant Is <br />unable to attend a scheduled meeting, please make arrangemei.ts to have an <br />authorized agent attend in your place and to advise the Building & Zoning <br />Office of this change prior to the mee'^lng.