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I Present Zoning District <br />0 <br />Present Use of Property <br />• ir <br />_ _ _ Residential,« <br />Other (specify; <br />DESCRIPTION OP REQUEST <br />Describe request in detail; ^rc ef'JiI cCr 77/-' <br />required submittals <br />1. Completed Application Form. <br />^^operty Owners List of owners within 3«;n' /, <br />this list from Hennepin County Department of obtaiCenter 348-3271). ^ department of Finance A-603 Governmer. <br />Plat Map. <br />survey (signed by a licensed surveyor) <br />2. <br />3. <br />4. <br />5. <br />6. <br />7.rirrd‘din"d^^t"o' ents). <br />any other persons you wish notified 'of tlfiV ap*yi?catior^^^ <br />YOU ARE REQUIRED TO SUPPLY 30 C0PTP<; nv Tunr^-r, .> <br />A WORKING COPY (11- X 17- OR DOCUMENTS OR <br />- - - - - - - - - - - --^ DOCUMENTS SUBMITTED. <br />The applicant and Property Owner mu*;t ei'em 4-u • "* —— <br />Use Application is complete. <br />__ _ _ Date <br />APPLICANT'S SIGNATURE ' <br />requested by the Zoi^Lifg Administrato/°I^^^ information required or <br />time not covered by original additional fees (staff <br />In review of this anni-f ^=.4.,-— __P y®ent) and/or unusual e.xpenses lncur-r*.fiin review of this application unusua^ e.xpenses Incurred <br />xs true and correct to the best of his/her knowledge.® information supplied <br />Applicant's signature <br />OWNERS SIGNATURE <br />The owner <br />- <br />•-/ <br />^^te )■■ U-7 <br />Owner's signature <br />j:Date <br />iSBSiiSiffil <br />LV-