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3/ ^0 ^3 <br />oo ^9-. liv <br />rrens? / <br />eluded <br />21d gggf/ <br />8c*f Zip SS^Z3 <br />th/year) <br />d. <br />4 ^ <br />be.) <br />ignated wetland or <br />IL <br />, cu. yd. or. more <br />ng walla within 75* <br />‘ • *' ‘i ^ ♦ <br />Itant fees) <br />^ A <br />X <br />«# a. <br />m <br />■•-■V <br />ft v> <br />.A <br />ti <br />•V- • • Jk^ <br />i1 <br />•j ’ <br />.Vf- <br />•:J <br />m <br />t. <br />V-i <br />u <br />pmssmr usb of property <br />Present Zoning District <e/e- i3 <br />Present Use of Property Residential <br />_ _ _ _ _ _ Other (specify) <br />fiSSCRIFTIOH OF RBQOST <br />Describe request in detail:Sag — <br />SDBMITTRLS <br />2. <br />3. <br />RBQOISBI <br />1. Completed Application Form. <br />Certified Property Owners List of owners within 350* (you can obtain <br />this list from Hennepin County Department of Finance A-603 Government <br />Center 348-3271) <br />Stamped, legal sized envelopes (#10) pre-addressed to each of the names <br />on the above list with no return address. <br />Certificate of survey. <br />Topographic survey (existing and proposed contours) if land <br />alterations involve changes in elevation (grades). <br />Construction plan, if applicable (see staff for requirements). <br />Plat Map. <br />As an addendum to this application, please attach a separate list of <br />any other persons you wish notified of this application. <br />4. <br />5. <br />6. <br />7. <br />8. <br />The applicant and Property Owner must sign this application. Please <br />remember that your application is not complete if the above information has <br />not been included. <br />Certification by Zoning Department that Land Use Application is complete. <br />Zoning Officials Signature Date <br />APFLICAHT'S SI6SASDRB <br />The applicant hereby agrees to provide all information required or <br />requested by the Zoning Administrator, agrees to pay all fees and/or <br />unusual expenses incurred in review of this application, and certifies that <br />the information supplied is true aj»4 correct to the best of his/her <br />knowledge. <br />Applicant's signature Date II-zt <br />ONHBRS SI6NATDRB <br />The owner hereby acknowledges and agrees to this application and further <br />authorized reasonable entry onto the property by City staff, consultants, <br />agents, commission members, and Council members for purposes of <br />investigation and ^rification of this request. <br />Owner's signature <br />Applicant must have all submittals into the City offices 25 days before^the <br />Planning Commission Meeting. Planning Commission Meetings are_held'on the <br />third Monday of each month. Applicants must be present at all'scheduled <br />review meetings of the Planning Commission and Council. If anjapplicant is <br />unable to attend a scheduled meeting, please make arrangements to~have an <br />authorized agent attend in your place and advise the Building & Zoning <br />Office of this change prior to the meeting. <br /># <br />r.0- <br />M <br />HQ <br />r ti <br />r V ;: OS. <br />To: <br />Re: <br />Froi <br />I ai <br />the <br />unii <br />and <br />I h< <br />bui! <br />ind( <br />for <br />str\ <br />I eu! <br />Hisi <br />wilJ <br />cle£ <br />coui <br />My c <br />my c <br />horns <br />my s <br />cont <br />Kent <br />witl" <br />in t <br />Plea