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?nF’ <br />M^n.f\\^i <br />"i /J '«<w f *'z____a-ns <br />i u'w/Vfa,\/V^Wv <br />;orrens7 ^:V <br />CHECK R <br />nclud hECEIPT-lhi^K WUlea,^.,CO£li ROl Ivy- <br />473-1271 <br />ke Zip 55356 <br />271 <br />Lake Zip 55356 <br />>nth/year) <br />ind. <br />eta.) <br />^slgnated wetland or <br />01 cu. yd. or more <br />ling walls within 75' <br />lultant fees) <br />flBSafV OSB OF PSOPBRTT <br />Present Zoning District <br />Present Use of Property Residential <br />other (specify) Industrial <br />OBSCXIPTIOli OP RBQOBST <br />Describe request in details Coaply witk10-87-200 Remedial Action Plan <br />RBQOISBD SPHTTRLS <br />1. Completed Application Form. <br />2. Certified Property Owners List of owners within 350* (you can obtai <br />this list from Hennepin County Department of Finance A-603 Governmen <br />Center 348-3271) , ^ <br />3. Stamped, legal sized envelopes (§10) pre-addressed to each of the name <br />on the above list with no return address. <br />4. Certificate of survey. <br />5. Topographic survey (existing and proposed contours) if land <br />alterations involve changes in elevation (grades). <br />6. Construction plan, if applicable (see staff for requirements). <br />7. Plat Map. <br />8. As an addendum to this application, please attach a separate list Of <br />any other p'^rsons you wish notified of this application. <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 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />APPLZCABT*S SIGBATORB ^ ^ <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 and correct to the best of his/her <br />Applicant's signature Date <br />ONHBRS SIGBATOBB ^ <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 verification of this request. <br />Owner's signature __________________________________ Date____________________ <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 an applicant 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 />m <br />M' <br />< <br />Sr-i-V-''i <br />m <br />f <br />' ■'■■■■-'ll <br />-Jwm <br />•V- <br />t t <br />i4i <br />% <br />m <br />N <br />IS <br />-5 <br />inm <br />^ lyA mi•n K a ^ <br />o o o S_ ^ o <br />HI <br />Oo I" <br />Uu M ^ <br />HI <br />CSJ <br />• <br />40 <br />3 ^ m <br />^ o u»M <br />I <br />HI <br />HI <br />gui <br /><B 4* Ul <br />o <br />o <br />cxa <br />“9 <br />5 <br />H- <br />CB <br />O _ <br />Q Z Ul S? >• V.• * ? ^ Q. LU Q. <br />OHi