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1 1 i i <• • j <br />(attach additional sheets if necessary) <br />lITThLS ition <br />3. <br />4. ' <br />3. 1 <br />latat <br />1, CoBplsted Application Form . w-. j <br />2^-Certified Property Owners List of owners within 150* (you must obtain <br />’- -Xiat from Hennepin County Department of Finance A-603 Govt Center <br />346-3271). <br />Plat Map (obtained with property owners list). <br />Certificate of survey (signed by a licensed surveyor) to include <br />hardcover calculations as required, (provide, one (1) copy SH-xll" for <br />Topographic survey (existing and proposed elevations) if any changes <br />in existing grade are proposed (provide one copy ). <br />SIcetches or ^ans of floor 4 elevation views (provide 1 copy 8ii xll ). <br />As an addendum to this application, please attach a separate list of <br />any other persons you wish notified of this application. <br />8._ _Mditional items as may be requested by City staff. <br />The Applicant and Property Owner must sign this application. <br />remember .that vonr veriemce amplication ie not complete _lf <br />inPmmaticm has not been included* ____ _ _ _ ___ _ _ _ _ <br />APPLICAMT*8 SIGMATfM . . _ <br />The applicant hereby agrees to provide all ^"^®”If^^*ir-/?21li^*ataff requested by the Zoning Administrator, agrees to pay additional fees (staff <br />tiSe not covered by original fee payment) <br />incurred in review of this application, and certifies that the information <br />supplied is true and correct to the best of higher Icnowledge. <br />6. <br />7.' <br />Applicant's Signature <br />Th. o.n.r h.r.by .ckovl.dgV. and agr... tp thi. applicatioB ^J^**^*J <br />authorl... rMSonabl. antry ont. th. proparty by City ataff, <br />aganta. Coi»ia.loi> meid>.r., and Council n«»b.r. for purpoM.-of inv.atiga <br />tion and verification of <br />Oimer's Signature ______oTftiif \JUe< Date <br />Applicant nuat hav. allCtittala into th. )ity t{|* <br />Pluming Cmmiaaion MaatA^ Plwming Comaia.ion Ma.ting. ar. hold t^ <br />third Monday of aach month. Applicant, moat ^ “ff <br />r..l«. iMOtiag. of th. PlauOng 00-1.100 mnd C^dl. If an <br />unabl. to attend a achadulad naating. plaaaa **?hj>*«Miiainc & Zonlnuauthor!.*! pg«it attend in your place and to advia. the Building a Zoning <br />Office'of this chcuige prior to the meeting. <br />forrect to the best of <br />Q J (i )J^ <br />- ________________A.WJ <br />Datm <br />m, . / • : <br />* a . • ^ "* ' t • <br />• • #«e